Molecular and Clinical Heterogeneity in Resected Biliary Tract Cancer: A Single-Center Analysis of Treatment Patterns and Oncologic Outcomes
- 1Department of Surgery, HPB Center, Clinic Favoriten, Health Network Vienna and Sigmund Freud Private University, 1100 Vienna, Austria
- 2Institute of Clinical Pathology, Molecular Pathology and Microbiology, Clinic Favoriten, Health Network Vienna, 1100 Vienna, Austria
- 3Department of Surgery, University Hospital Wiener Neustadt, 2700 Wiener Neustadt, Austria
Abstract
Background/Objectives: Biliary tract cancer (BTC) comprises anatomically and molecularly distinct diseases, yet real-world data integrating molecular testing with clinicopathological characteristics and outcomes after resection remain limited. We evaluated clinical and molecular heterogeneity across the major BTC subtypes in a contemporary surgical cohort. Methods: Consecutive adults undergoing curative-intent resection for intrahepatic (iCCA), perihilar (pCCA), distal (dCCA) cholangiocarcinoma, or gallbladder cancer (GBC) at a single Vienna center between 2019 and 2025 were analyzed at the patient level using the first qualifying resection as the index procedure. Molecular testing (52-gene Oncomine Focus; 50-gene Precision/Genexus), perioperative and pathological outcomes, recurrence, and overall survival (OS) were assessed. Results: The cohort included 145 patients (73 iCCA, 24 pCCA, 22 dCCA, 26 GBC). Molecular profiling was available in 103 patients (71%). IDH1/2 and FGFR2 alterations were confined to iCCA, whereas KRAS alterations were most frequent in pCCA and dCCA. Major morbidity occurred in 54/145 patients (37%) and was highest in pCCA (16/24, 67%); 17 Grade V events were documented. Median OS was 40.0 months and did not differ significantly across anatomical subtypes (log-rank p = 0.250). Cumulative incidence of recurrence likewise did not differ significantly across subtypes when death without prior recurrence was treated as a competing event (Gray’s test p = 0.163). Conclusions: The principal contribution of this real-world cohort is the integration of routine molecular testing with surgical, pathological, treatment, perioperative, and longitudinal outcome data across resected BTC subtypes. Assay coverage and testing selection must be considered when interpreting molecular findings generated in routine practice.
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BibTeX
@article{dong2026molecular,
title = {{Molecular and Clinical Heterogeneity in Resected Biliary Tract Cancer: A Single-Center Analysis of Treatment Patterns and Oncologic Outcomes}},
author = {Yawen Dong and Sophia Petschnak and Matthias Novotny and Francesca Notte and Madita Tschoegl and Edanur Cenan and Jonas Santol and Mariel Gramberger and Mohamed Salem and Alexander Kupis and Rebecca Thonhauser and Niccolò Surci and Josef Friedl and Thomas Hoblaj and Thomas Gruenberger},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18213472},
url = {https://www.mdpi.com/2072-6694/18/21/3472},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Molecular and Clinical Heterogeneity in Resected Biliary Tract Cancer: A Single-Center Analysis of Treatment Patterns and Oncologic Outcomes
AU - Yawen Dong
AU - Sophia Petschnak
AU - Matthias Novotny
AU - Francesca Notte
AU - Madita Tschoegl
AU - Edanur Cenan
AU - Jonas Santol
AU - Mariel Gramberger
AU - Mohamed Salem
AU - Alexander Kupis
AU - Rebecca Thonhauser
AU - Niccolò Surci
AU - Josef Friedl
AU - Thomas Hoblaj
AU - Thomas Gruenberger
PY - 2026
DA - 2026/10/27
JO - Cancers
DO - 10.3390/cancers18213472
UR - https://www.mdpi.com/2072-6694/18/21/3472
AB - Background/Objectives: Biliary tract cancer (BTC) comprises anatomically and molecularly distinct diseases, yet real-world data integrating molecular testing with clinicopathological characteristics and outcomes after resection remain limited. We evaluated clinical and molecular heterogeneity across the major BTC subtypes in a contemporary surgical cohort. Methods: Consecutive adults undergoing curative-intent resection for intrahepatic (iCCA), perihilar (pCCA), distal (dCCA) cholangiocarcinoma, or gallbladder cancer (GBC) at a single Vienna center between 2019 and 2025 were analyzed at the patient level using the first qualifying resection as the index procedure. Molecular testing (52-gene Oncomine Focus; 50-gene Precision/Genexus), perioperative and pathological outcomes, recurrence, and overall survival (OS) were assessed. Results: The cohort included 145 patients (73 iCCA, 24 pCCA, 22 dCCA, 26 GBC). Molecular profiling was available in 103 patients (71%). IDH1/2 and FGFR2 alterations were confined to iCCA, whereas KRAS alterations were most frequent in pCCA and dCCA. Major morbidity occurred in 54/145 patients (37%) and was highest in pCCA (16/24, 67%); 17 Grade V events were documented. Median OS was 40.0 months and did not differ significantly across anatomical subtypes (log-rank p = 0.250). Cumulative incidence of recurrence likewise did not differ significantly across subtypes when death without prior recurrence was treated as a competing event (Gray’s test p = 0.163). Conclusions: The principal contribution of this real-world cohort is the integration of routine molecular testing with surgical, pathological, treatment, perioperative, and longitudinal outcome data across resected BTC subtypes. Assay coverage and testing selection must be considered when interpreting molecular findings generated in routine practice.
SN - 2072-6694
ER -