Proposed Definition for Oligometastatic Recurrence in Biliary Tract Cancer Based on Results of Locoregional Treatment: A Propensity-Score-Stratified Analysis

  • Koshiro Morino
  • Satoru SeoEmail author
  • Tomoaki Yoh
  • Ken Fukumitsu
  • Takamichi Ishii
  • Kojiro Taura
  • Satoshi Morita
  • Toshimi Kaido
  • Shinji Uemoto
Hepatobiliary Tumors



Oligometastatic recurrence involves relapsed tumors for which locoregional treatment (LT) may yield a survival benefit. However, there are no clear criteria for selecting patients for LT or determining the effects of LT in recurrent biliary tract cancer (BTC). The aim of this retrospective study is to assess the effects of LT on survival outcomes and to identify potential criteria for selecting LT in recurrent BTC.

Patients and Methods

In the present work, 232 consecutive patients with recurrent BTC who initially underwent curative surgery between 1996 and 2015 were evaluated. The primary outcome was length of survival after recurrence (SAR). Propensity score stratification with various tumor-related factors was used to identify patients who would likely benefit from LT.


Among the cohort, 60 (25.9%) patients underwent LT, whereas 172 (74.1%) patients did not. The multivariate Cox model identified carbohydrate antigen 19-9 levels of > 50 U/mL, multiorgan recurrence, tumor number > 3, tumor size > 30 mm, and early recurrence (≤ 1 year) as independent predictors of poor SAR (P < 0.001 for each factor). In the propensity-score-stratified analysis, LT was associated with survival benefits for patients representing single-organ recurrence with at most three tumors and late-onset recurrence (> 1 year) (median SAR: 48.6 vs. 14.2 months, n = 33 vs. n = 34, hazard ratio: 0.10, 95% confidence interval: 0.04–0.20, P < 0.001).


Patients with recurrent BTC may benefit from LT if they have single-organ recurrence with at most three tumors and late-onset recurrence. We propose that these patients may have clinically relevant “oligometastatic recurrence” of BTC.


Oligometastasis Oligorecurrence Biliary tract cancer Locoregional treatment 



We would like to thank Editage ( for English language editing.


No financial support was received for this report.


There are no conflicts of interest to declare.

Supplementary material

10434_2020_8207_MOESM1_ESM.docx (27 kb)
Supplementary material 1 (DOCX 27 kb)


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Copyright information

© Society of Surgical Oncology 2020

Authors and Affiliations

  • Koshiro Morino
    • 1
  • Satoru Seo
    • 1
    Email author
  • Tomoaki Yoh
    • 1
  • Ken Fukumitsu
    • 1
  • Takamichi Ishii
    • 1
  • Kojiro Taura
    • 1
  • Satoshi Morita
    • 2
  • Toshimi Kaido
    • 1
  • Shinji Uemoto
    • 1
  1. 1.Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Department of Biomedical Statistics and Bioinformatics, Graduate School of MedicineKyoto UniversityKyotoJapan

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