Oncological outcomes in a cohort of patients with biliary tract carcinoma in a Mexican reference center.

Abstract

e15618 Background: In Mexico there is scarce information about oncological outcomes of biliary tract carcinomas (BTC). Methods: we retrospectively reviewed medical records from 150 patients with histologically confirmed BTC (excluding gallbladder cancer) treated in our institution from January 2005 to December 2015.Clinical and pathological information was recorded. Survival was estimated by Kaplan Meir method and compared by Log rank test. Results: we found 63.3% women and 36.7% men, with a median age of 62 years (23 - 88). Tumor localization was intrahepatic in 34.7%, hilar in 43.3% and distal in 22%. Clinical stage was advanced in 71%, regional in 13% and local in 16%. Diagnostic delay was 3.7 months (0.37 - 32.9). For patients with localized disease (which included local and regional disease, n=43), a potentially curative surgery was attempted in 64% (n=27), achieving a R0 resection in 59% (n=16) of cases. There was a 3.9 months (0.83-29.63) treatment initiation delay. There were 7 surgical deaths. For advanced disease (n=107), treatment initiation delay was 4.2 months (0.5 - 34.5), 59% (n=63) of patients did not received oncological active treatment, and 26% (n=28) of patients received a systemic palliative chemotherapy, more frequently gemcitabine (n=20). At progression just eleven patients received a second chemotherapy line. In localized disease resected patients by univariate analysis high levels of CA 19.9 (p=0.04) and CEA (0.03) were associated with decreased survival. For patients with advanced disease prognostic factors included poorly differentiated histology (p=0.04), high bilirrubin level (p=0.04), low albumin level (p=0.001), abscense of chemotherapy (p=0.000) and high CEA levels (p=0.03). Conclusions: Survival is poor in this Mexican cohort of patients with BTC possibly related to diagnostic and therapeutic delay and advanced disease at presentation. [Table: see text]