Abstract
IntroductionBiliary tract cancers (BTCs) are rare tumours with regional differences. Prognostic factors are poorly understood. Gemcitabine + platinum (GP) is the standard first-line chemotherapy in metastatic patients. We aimed to search for prognostic factors in patients with advanced disease in a cancer centre in South America.MethodsWe conducted a retrospective analysis of patients with advanced BTC treated with chemotherapy. Variables were age (< or ≥70 years), Eastern Cooperative Oncology Group (ECOG) performance status (0/1 versus 2/3), gender, primary site (intrahepatic (IHC), extrahepatic (EHC), gallbladder (GB)), staging (locally advanced versus metastatic), metastatic sites, albumin (>3.5 g/dL versus <3.5 g/dL), biliary obstruction and first-line chemotherapy (GP, 5FU-based or single-agent). Cox regression method was used to explore factors.ResultsFrom 2010 to 2017, 104 patients were included. Median age was 62 years (32–86) and 22.1% were older than 70 years. Most patients had ECOG performance status 0/1 (63.4%), were female (51.9%) and were metastatic (82.7%). Bone metastases were found in 19.2%. Primary IHC, EHC and GB were 54.8%, 36.5% and 8.7%, respectively. GP was used by 79.8%. Median follow-up was 32.4 months. Median overall survival (mOS) was 11.4 months. In univariate analysis, male (p = 0.007), albumin < 3.5 g/dL (p = 0.001), biliary obstruction (p = 0.006), 5FU-based (p = 0.006) and single-agent (p < 0.0001) were associated with worse OS. ECOG performance status 2/3 (p = 0.058) and bone metastases (p = 0.051) were marginally related. In multivariate analysis, male (p = 0.003), bone metastases (p = 0.023), biliary obstruction (p = 0.001), 5FU-based (p = 0.016) and single-agent (p = 0.023) were independently associated with inferior OS.ConclusionIn this retrospective study, we observed that male patients, bone metastases, biliary obstruction and regimens other than GP had worse survival. Larger studies should be conducted to confirm our findings.
Highlights
Biliary tract cancers (BTCs) are rare tumours with regional differences
Male (p = 0.003), bone metastases (p = 0.023), biliary obstruction (p = 0.001), 5FU-based (p = 0.016) and singleagent (p = 0.023) were independently associated with inferior Overall survival (OS). In this retrospective study, we observed that male patients, bone metastases, biliary obstruction and regimens other than Gemcitabine + platinum (GP) had worse survival
We aim to describe main prognostic factors for metastatic BTC in a South American cohort of patients treated at a large cancer centre, who received first-line chemotherapy
Summary
Biliary tract cancers (BTCs) are rare tumours with regional differences. Gemcitabine + platinum (GP) is the standard first-line chemotherapy in metastatic patients. We aimed to search for prognostic factors in patients with advanced disease in a cancer centre in South America. Biliary tract cancers (BTCs) are a rare group of malignances [1]. An increase in the incidence of IHC has been described [3]. Gemcitabine plus Cisplatin (GC) is considered the standard therapy in the first-line setting based in the ABC-02 trial. Main prognostic factors are poorly defined due to the rarity and heterogeneity of this disease. We aim to describe main prognostic factors for metastatic BTC in a South American cohort of patients treated at a large cancer centre, who received first-line chemotherapy
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