Surgery remains the main curative-intent therapy for distal cholangiocarcinoma (DCC). Nevertheless, over half of patients with DCC will recur even after curative-intent resection. Despite the increasing use of adjuvant therapies (AT) for biliary tract cancers (BTCs),
1 the majority of patients with DCC will have early recurrence (ER) following resection, which is associated with a dismal prognosis.
2,
3 To this end, there is a need for better predictive tools to identify the subset of patients who are at particularly high risk of ER to help inform which individuals may benefit the most from early systemic therapy rather than upfront surgery. …