“…Consequently, a prerequisite for the results of costeffectiveness studies to be applicable in clinical practice is accurate prediction of survival, and the following factors at the time of diagnosis have been suggested to significantly predict shorter overall survival: distant metastases (mainly in the liver), 40,51,80,[82][83][84]87,94 greater the size of primary tumor, 51,57,80,83 laboratory findings (initially high bilirubin, 68,98 urea, 85 or leucocyte count 27 and low hemoglobin 85 or albumin 73 levels), pain, 68 or a combination of those factors. 93 Some malignancies causing hilar obstruction have 27,67,70,71 or have not 65,75 been found associated with a significantly poorer prognosis, and reportedly also with longer survival.…”