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Updated: Feb 19, 2026
05:36
Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
750
Proposal for Risk-Adjusted Surveillance Strategies in Extrahepatic Bile Duct Cancer with Cost-Effectiveness
Jae Sik Kim1, Jinsil Seong2, Kyubo Kim3
1Department of Radiation Oncology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea.
International Journal of Radiation Oncology, Biology, Physics
|February 17, 2026
Summary
A new risk-adjusted strategy for extrahepatic bile duct cancer survivors improves recurrence detection and reduces unnecessary follow-up visits. This personalized approach enhances survivorship care efficiency and cost-effectiveness.
Area of Science:
- Oncology
- Surgical Oncology
- Cancer Survivorship
Background:
- Extrahepatic bile duct (EHBD) cancer requires effective post-treatment surveillance.
- Current surveillance strategies may not be optimized for individual patient risk profiles.
Purpose of the Study:
- To develop a risk-adjusted surveillance strategy for EHBD cancer patients post-curative resection.
- To incorporate prognostic factors for disease-free survival (DFS) into the surveillance model.
Main Methods:
- Retrospective analysis of 1,443 EHBD cancer patients (2000-2015).
- Multivariate Cox models and random survival forest (RSF) identified prognostic factors for DFS.
- Surveillance intervals were set based on a 7% incremental risk of recurrence or death.
Main Results:
- Adverse prognostic factors for DFS included advanced tumor stage, positive lymph nodes, margin involvement, poor differentiation, and perineural invasion.
- Favorable outcomes were associated with distal tumors and concurrent chemoradiotherapy with maintenance chemotherapy.
- The RSF model generated risk-adjusted survival curves, defining 8-9 follow-up visits over 5 years for different radiotherapy statuses.
Conclusions:
- A risk-adjusted model tailored to prognostic factors and radiotherapy status enables individualized surveillance for EHBD cancer.
- This approach improves recurrence detection rates and reduces unnecessary patient visits.
- The strategy supports efficient and cost-effective survivorship care for cancer survivors.
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