726P - Natural history of untreated patients who had metastatic biliary tract cancer (BTC) with good performance status (PS)

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Hepatobiliary Cancers
Presenter Ayoung Seo
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors A. Seo1, J.H. Ji2, H. Song3, R.B. Kim4, S.Y. Oh5, H.Y. Lim6, J.O. Park7, S.H. Park8, M.J. Kim3, J.H. Kang9, S. Lee10, I.G. Hwang11, J. Jang11, H.J. Kim12
  • 1Health Promotion Center, Samsung Changwon Hospital, KR011 - Changwon/KR
  • 2Division Of Hematology And Oncology, Department Of Medicine, Samsung Changwon Hospital, Masan/KR011 - Changwon/KR
  • 3Division Of Hematology-oncology, Department Of Internal Medicine, Gyeongsang National University Hospital, ASI|KR|KS011|JINJU - Jinju/KR
  • 4Preventional Medicine, , Dong-A University College of Medicine, ASI|KR|KS012|PUSAN - Busan/KR
  • 5Department Of Internal Medicine, , Dong-A University College of Medicine, ASI|KR|KS012|PUSAN - Busan/KR
  • 6Division Of Hematology And Oncology, Department Of Medicine, Samsung Medical Center, ASI|KR|KS013|SEOUL - Seoul/KR
  • 7Department Of Internal Medicine, Hematology, Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine, 135-710 - Seoul/KR
  • 8Internal Medicine, Sam Sung Medical Center, Seoul/KR
  • 9Internal Medicine, Gyeongsang University Hospital, 660-702 - Jinju/KR
  • 10Hematology/oncology, Dankook University Hospital, KR-330-715 - Cheonan/KR
  • 11Internal Medicine Division Of Hematology/medical Oncology, Chung-Ang University Hospital, 156-755 - Seoul/KR
  • 12Department Of Internal Medicine, Gyeongsang National University Hospital, ASI|KR|KS011|JINJU - Jinju/KR

Abstract

Aim

Although chemotherapy is widely recommended for patients with metastatic biliary tract cancer (BTC), the natural course of these patients, especially those with good performance status (PS) who are indicated for chemotherapy, is not known.

Methods

We retrospectively reviewed patients with metastatic or locally advanced BTC who were examined between January 2005 and September 2013 at six cancer centers. Patients were eligible if they had good PS (Eastern Cooperative Oncology Group score 0-2) and no history of any treatment for cancer. The primary objective was to evaluate the survival time of patients with advanced BTC with good PS who were untreated.

Results

Of the 1,677 screened patients, 204 met the inclusion criteria. The median age was 70.1 years and median overall survival (OS) was 7.1 months. OS by disease location was 4.7 months for intrahepatic, 9.7 months for extrahepatic, 4.4 months for gallbladder, and 11.2 months for ampulla of Vater cancer. In subgroup analysis, OS of locally advanced BTC was 13.8 months and that of patients with normal CEA/CA 19-9 was 10.6 months. In multivariate analysis, variables that were associated with poor prognosis were disease extent (metastatic disease) [HR 2.19 (95% CI 1.39-3.45 p = 0.001)], high baseline CEA level (defined as > 4.0 ng/mL) [HR 1.51 (95% CI 1.06-2.17 p = 0.024)], and high baseline CA 19-9 level (defined as > 100 U/mL) [HR 1.93 (95% CI 1.33-2.91 p = 0.001)].

Conclusions

Metastatic BTC with good PS showed modest survival without any treatment for primary cancer. Furthermore, subgroup analysis showed that patients with normal CA19-9 or CEA level or locally advanced status had favorable survival. Further studies comparing the outcome of chemotherapy with that of best supportive care in patients with unresectable BTC are warranted.

Disclosure

All authors have declared no conflicts of interest.