What question did this study set out to answer?

This research aims to evaluate the survival outcomes and identify prognostic factors in early-onset biliary tract cancer (EOBTC).

March 28, 2026Open Access

Resectable Stage Early-Onset Biliary Tract Cancer: Survival and Prognostic Scoring (EOB-RS and EOB-OS) in Turkish Patients (TOG/GI-SAFRADJU-2502-EO)

Key Points

This research aims to evaluate the survival outcomes and identify prognostic factors in early-onset biliary tract cancer (EOBTC).
Conducted a multicenter registry analysis of resected biliary tract cancer patients in Turkey.
Compared characteristics and survival between early-onset and non-early-onset biliary tract cancer patients.
Analyzed prognostic factors for recurrence-free and overall survival using hazard ratios.
12.6% of the included patients had early-onset biliary tract cancer.
R1 resection rates were higher in early-onset patients (37.1% vs. 25.7%).
Both recurrence-free survival and overall survival were similar between early-onset and non-early-onset groups suggesting comparable outcomes.

Abstract

PURPOSE Early-onset gastrointestinal cancers are concerning entities globally, yet early-onset biliary tract cancers (EOBTCs) are understudied. Early-stage disease is crucial for young patients' survival. METHODS TOG/GI-SAFRADJU (ClinicalTrials.gov identifier: NCT06975917 ) is a multicenter, hospital-based, registry initiative of the Turkish Oncology Group, including patients with resected BTCs. Early-onset was defined as a diagnosis at age <50 years. Characteristics and survival of EOBTC and non-EOBTC were compared. Among patients with EOBTC, prognostic factors for recurrence-free survival (RFS) and overall survival (OS) were analyzed. Risk scores were assigned on the basis of hazard ratios. RESULTS Six hundred seventeen patients from 44 centers were included. 12.6% (n = 78) were EOBTC. R1 resection rate was significantly higher among EOBTC (37.1% v 25.7%, P = .038). Adjuvant treatments did not differ between EOBTC and non-EOBTC. Among patients who received adjuvant chemotherapy, RFS (13.9 months 95% CI, 11.4 to 22.1 v 15.9 months 95% CI, 13.6 to 18.9, P = .947) and OS (35.6 months 95% CI, 28.0 to 81.4 v 31.3 months 95% CI, 27.8 to 44.3, P = .670) were similar between EOBTC and non-EOBTC groups. Among patients with EOBTC, R1-resection and high CA19-9 levels were associated with shorter RFS, and gallbladder localization and high CA19-9 were associated with shorter OS in adjusted analyses. Using these factors, risk scores early-stage EOBTC RFS score (EOB-RS) for RFS and early-stage EOBTC OS score (EOB-OS) for OS were formed, each including three ranks. Both scores significantly ordered the prognosis of patients with EOBTC (EOB-RS, 0 points: 22.7 months, 1 or 2: 10.3 months, 3: 5.7 months, P < .001, EOB-OS: 0: 110.9 months, 1 or 2: 29.6 months, 3: 10.1 months, P < .001). CONCLUSION Resected EOBTC patients showed survival comparable to older counterparts receiving surgery/adjuvant therapy. This study suggests a potential risk scoring system for early-stage EOBTC, pending validation.

Read Full Paperexternally

Bookmark

View Full Paper

Cite This Study

Akkus et al. (Sun,) studied this question.

synapsesocial.com/papers/69c771dd8bbfbc51511e1f8b https://doi.org/https://doi.org/10.1200/go-25-00655

Bookmark

View Full Paper