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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
Conditional survival after curative resection for extrahepatic cholangiocarcinoma: a comprehensive analysis of
Hea Lim Choi1, Danbee Kang2, In Woon Han3
1Center for Trend Monitoring-Risk Modeling, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation, The Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
Background:
Conditional survival offers dynamic, time-adjusted prognostic information but remains understudied in extrahepatic cholangiocarcinoma (EHCC). This study evaluated conditional overall survival (COS), conditional recurrence-free survival (CRFS), and conditional relative survival (CRS) after curative-intent resection for EHCC.
Methods:
We conducted a retrospective cohort study of 1266 patients who underwent curative-intent resection for EHCC (hilar, n = 424; common bile duct cancer [CBDC], n = 842) at a single institution between 2005 and 2019. Conditional 5-year COS, CRFS, and CRS were calculated annually using Kaplan-Meier methods and compared across demographic, clinical, and tumor-related subgroups.
Results:
At baseline, 5-year COS, CRFS, and CRS were 41.3 %, 29.3 %, and 47.9 %, respectively, improving to 51.9 %, 50.0 %, and 59.3 % at five years post-surgery. Stage III patients demonstrated the largest gains in COS (24.7 %-51.0 %) and CRFS (14.6 %-53.3 %). Younger patients and females consistently had superior outcomes, whereas obese patients and those receiving adjuvant therapy showed less favorable long-term trends. Conditional survival patterns were similar between hilar and CBDC.
Conclusion:
Conditional survival in EHCC improves substantially with time survived, particularly among advanced-stage, younger, and female patients. However, nearly 40 % remain at risk of recurrence even after 5 recurrence-free years. Conditional estimates provide dynamic insights to guide counseling and surveillance.
