{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:33:05Z","timestamp":1789831985275,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Liver failure and biliary tract cancer (BTC) are major life\u2010threatening events in the clinical course of primary sclerosing cholangitis (PSC). Although these are competing events, they are typically evaluated as a composite prognostic endpoint. In Japan, the clinical characteristics and prognosis of PSC reportedly differ according to age of onset. We compared the prognosis of younger\u2010 versus older\u2010onset PSC by competing risk analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective analysis of 144 patients with PSC who were followed up for a median of 6.7\u00a0years. The patients were divided into two groups according to a cutoff age of onset of 44\u00a0years. We compared the prognosis of younger\u2010onset PSC (n\u00a0=\u00a091) and older\u2010onset PSC (n\u00a0=\u00a053) by competing risk analysis, incorporating mortality related and that unrelated to BTC as competing events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference in BTC\u2010related mortality between patients with younger\u2010onset and those with older\u2010onset PSC (subdistribution hazard ratio [SHR], 0.89; 95% confidence interval [CI], 0.17\u20104.56, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.888). The cumulative incidence of mortality due to other causes, including liver transplantation and liver failure, was non\u2010significantly higher in patients with older\u2010onset PSC (SHR, 1.58; 95% CI, 0.88\u20102.84; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.129).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although we did not find a significant difference in prognosis by onset age, patients with older\u2010onset PSC had worse liver\u2010transplantation\u2010free survival than those with younger\u2010onset PSC. A large cohort study is needed to evaluate the clinical outcomes of older\u2010 and younger\u2010onset PSC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.952","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T05:05:16Z","timestamp":1617426316000},"page":"1115-1120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognosis of primary sclerosing cholangitis according to age of onset"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4097-3758","authenticated-orcid":false,"given":"Takeo","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Graduate School of Medicine The University of Tokyo Tokyo Japan"},{"name":"Department of Gastroenterology The Fraternity Memorial Hospital Tokyo 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Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8734-740X","authenticated-orcid":false,"given":"Kiyoshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Artificial Organ and Transplantation Surgery Division Department of Surgery Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3308-9326","authenticated-orcid":false,"given":"Hiroyuki","family":"Isayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Graduate School of Medicine Juntendo University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9787-1907","authenticated-orcid":false,"given":"Kazuhiko","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Graduate School of Medicine The University of Tokyo Tokyo 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