{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T21:01:16Z","timestamp":1774558876253,"version":"3.50.1"},"reference-count":19,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n PURPOSE<\/jats:title>\n Early-onset gastrointestinal cancers are concerning entities globally, yet early-onset biliary tract cancers (EOBTCs) are understudied. Early-stage disease is crucial for young patients' survival.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n TOG\/GI-SAFRADJU (ClinicalTrials.gov identifier:\n NCT06975917<\/jats:ext-link>\n ) is a multicenter, hospital-based, registry initiative of the Turkish Oncology Group, including patients with resected BTCs. Early-onset was defined as a diagnosis at age <50 years. Characteristics and survival of EOBTC and non-EOBTC were compared. Among patients with EOBTC, prognostic factors for recurrence-free survival (RFS) and overall survival (OS) were analyzed. Risk scores were assigned on the basis of hazard ratios.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Six hundred seventeen patients from 44 centers were included. 12.6% (n = 78) were EOBTC. R1 resection rate was significantly higher among EOBTC (37.1%\n v<\/jats:italic>\n 25.7%,\n P<\/jats:italic>\n = .038). Adjuvant treatments did not differ between EOBTC and non-EOBTC. Among patients who received adjuvant chemotherapy, RFS (13.9 months [95% CI, 11.4 to 22.1]\n v<\/jats:italic>\n 15.9 months [95% CI, 13.6 to 18.9],\n P<\/jats:italic>\n = .947) and OS (35.6 months [95% CI, 28.0 to 81.4]\n v<\/jats:italic>\n 31.3 months [95% CI, 27.8 to 44.3],\n P<\/jats:italic>\n = .670) were similar between EOBTC and non-EOBTC groups. Among patients with EOBTC, R1-resection and high CA19-9 levels were associated with shorter RFS, and gallbladder localization and high CA19-9 were associated with shorter OS in adjusted analyses. Using these factors, risk scores early-stage EOBTC RFS score (EOB-RS) for RFS and early-stage EOBTC OS score (EOB-OS) for OS were formed, each including three ranks. Both scores significantly ordered the prognosis of patients with EOBTC (EOB-RS, [0 points]: 22.7 months, [1 or 2]: 10.3 months, [3]: 5.7 months,\n P<\/jats:italic>\n < .001, EOB-OS: [0]: 110.9 months, [1 or 2]: 29.6 months, [3]: 10.1 months,\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Resected EOBTC patients showed survival comparable to older counterparts receiving surgery\/adjuvant therapy. This study suggests a potential risk scoring system for early-stage EOBTC, pending validation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1200\/go-25-00655","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T19:59:11Z","timestamp":1774555151000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Resectable Stage Early-Onset Biliary Tract Cancer: Survival and Prognostic Scoring (EOB-RS and EOB-OS) in Turkish Patients (TOG\/GI-SAFRADJU-2502-EO)"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7531-7817","authenticated-orcid":true,"given":"Erman","family":"Akkus","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey"},{"name":"Cancer Research Institute, Ankara University, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5424-3161","authenticated-orcid":true,"given":"Mehmet","family":"Kayaalp","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey"},{"name":"Cancer Research Institute, Ankara University, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00fczeyyen Asl\u0131","family":"Erg\u00f6zo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9797-8037","authenticated-orcid":true,"given":"Ilg\u0131n","family":"Ko\u00e7 Ku\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Do\u011fan","family":"Bayram","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bilge\u015fah","family":"K\u0131l\u0131\u00e7ta\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emel","family":"Ayvaz G\u00fcneyin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Atat\u00fcrk University, Erzurum, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Kalem","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6412-0277","authenticated-orcid":true,"given":"Haydar","family":"Temizy\u00fcrek","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Afyonkarahisar University of Health Sciences, Afyon, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0425-3438","authenticated-orcid":true,"given":"Mehmet Mutlu","family":"\u00c7atl\u0131","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Antalya Training and Research Hospital, Antalya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5513-4351","authenticated-orcid":true,"given":"Mehmet Sinan","family":"Akarca","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, \u0130zmir, 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