{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:06:32Z","timestamp":1784199992982,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Upper gastrointestinal bleeding (UGIB) is associated with an unfavorable outcome in cancer patients. In patients with biliary tract cancer (BTC), data on the incidence, management, and prognostic implications of UGIB are limited. This study investigated the prevalence, treatment efficacy, and prognostic factors associated with UGIB in BTC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study included all patients with BTC and UGIB, treated at a tertiary care center between 2010 and 2023. Clinical, laboratory, endoscopic, and survival data were obtained from hospital records. Outcomes included short\u2010term rebleeding within 14\u2009days and overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1033 BTC patients, 37 (3.6%) experienced UGIB. The predominant etiologies were tumor\u2010associated bleeding due to tumor infiltration (27.0%), variceal bleeding (21.6%), and ulcer bleeding (16.2%). Endoscopic therapy was performed in 43.2% of cases, achieving hemostasis in 78.6% of actively bleeding patients. Short\u2010term rebleeding occurred in 28.6%. The 30\u2010day mortality following UGIB was 35.7%. Tumor\u2010associated UGIB correlated with significantly increased mortality (HR\u2009=\u20092.83, 95% CI 1.1\u20137.27,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) and markedly reduced overall survival (28 vs. 90\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>UGIB is a rare but severe complication in BTC. Tumor\u2010associated UGIB was associated with poor prognosis and markedly shortened survival, underscoring the necessity for careful clinical assessment and close follow\u2010up in this high\u2010risk cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72039","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:57:01Z","timestamp":1781495821000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Upper Gastrointestinal Bleeding is Associated With Poor Prognosis in Patients With Biliary Tract Cancer"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8817-2947","authenticated-orcid":false,"given":"Jan Christoph","family":"Schumacher","sequence":"first","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Lang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Kasper","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Martin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Waldschmidt","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8940-7696","authenticated-orcid":false,"given":"Martin","family":"B\u00fcrger","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"T\u00f6x","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department of Gastroenterology and Hepatology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Neumann\u2010Haefelin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital of Cologne, Department 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