Biliary tract cancer in a Moroccan medical oncology unit.

Abstract

e14726 Background: Biliary tract cancers (BTC) are relatively rare (3% of digestive cancers), they mainly affect older women and are located in the gallbladder in about 70% of the cases. Methods: In this retrospective study, we reviewed 63 cases of BTC admitted in the medical oncology unit of HASSAN II university center between January 2007 and December 2011. The aim of this study is to define epidemiologic, diagnostic and therapeutic aspects of this disease in a Moroccan population. Results: In our study, BTC account for 4,9% of digestive cancers. The mean age of our patients was 58,2 years ranged from 32 to 81 years, female gender represent 69%. The tumors were located in the gallbladder (GB) in 70% of the cases divided into adenocarcinoma (79%) and squamous cell carcinoma (21%). The other locations were hilar cholangiocarcinoma (24%) and intrahepatic cholangiocarcinoma (6%). Magnetic resonance cholangiographic was performed (n=15) and suspected cancer in all cases. Incidental finding of GB cancer at surgery was recorded in 21 patients: intraoperatively in 8 cases or after pathological study in 13 cases. Staging of the disease was divided into localized stage (7%), locally advanced stage (13%) and metastatic stage (80%). A complete surgery in GB cancer was performed in 13 patients, a palliative surgery was done in 20 patients: cholecystectomy (n=7) and biliary drainage (n=13). For metastatic patients (n=44), a palliative chemotherapy was administred as following: combination of cisplatin and gemcitabin (n=18), gemcitabin (n=7), combination of cisplatin and 5 fluoro uracile (n=5), combination of oxaliplatin and gemcitabin (n=3), capecitabine (n=3), FUFOL Mayo clinic (n=2) and combination of capecitabine and oxaliplatin (n=2). While 9% of the patients received supportive care because of their comorbidities and the deterioration of the performans status and liver blood tests. Conclusions: Because of the silent evolution of BTC, the diagnosis is therefore delayed, the prognosis is poor and treatment is usually palliative. Our results are consistent with those of the literature concerning the epidemiological finding and diagnosis aspects.A multidisciplinary approach is recommended to improve the prognosis of patients with BTC.