265P - Epidemiology, outcome and prognostic factors of biliary tract cancer in the Tunisian population

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Hepatobiliary Cancers
Aetiology, Epidemiology, Screening and Prevention
Presenter Soumaya Labidi
Citation Annals of Oncology (2016) 27 (suppl_9): ix68-ix85. 10.1093/annonc/mdw582
Authors S. Labidi, M. Nasri, H. El Benna, N. Mejri, M. Afrit, H. Rachdi, H. Boussen
  • Medical Oncology, Abderrahmen Mami Hospital, 2080 - Ariana/TN



We aim to report epidemiological features, outcome, and prognosis of cholangiocarcinoma in a Tunisian population and try to identify its potential prognostic factors.


Data of 51 patients treated from 2012 to 2015 were collected from the department dataset, including: patient’s characteristics, radiologic and biologic findings, treatment modalities and outcome. Kaplan Meier method and Cox proportional hazards analysis were used to relate clinical variables to overall survival (OS).


Median age was 58 years (range 40- 89 years), 53% were males. PS was 0-1 in 74%, and an average BMI of 24.6 kg/m2. Serum CA19-9 and CEA were increased in 43% and 23.5% of cases respectively. Primary tumor sites were gallbladder in 45% of cases, the hepatic hilum in 22%, intrahepatic in 20% and low bile duct in 14% of cases. Only 9 patients underwent curative surgery, followed by adjuvant gemcitabine-based chemotherapy in 5 cases. Neoadjuvant chemotherapy was indicated for 13 patients (Gemox regimen 8 cases, Gemcis 3 cases and gemcitabine 2 cases). Disease was diagnosed at metastatic stage in 53% of cases, mostly to liver (78%) and peritoneum (30%). First line chemotherapy regimens were gemcitabine based in most cases (17/19cases). The median OS was 12 months for patients treated with curative intent, and 9 months in the palliative setting. Median time to progression was 4 months, and 40.7% of the patients could have a 2nd line treatment. In the univariate analysis, age less than 50 years (p = 0.038, HR = 3.2 [95% CI, 2.05-5.01]), good PS(0-1) (p = 0.000, HR = 1.03[95% CI, 1.02-1.067]), adjuvant chemotherapy (p = 0.029, HR = 4.78 [95% CI, 1.14-19.94]) and surgical treatment with curative purpose (p = 0.018, HR = 2.87 [95% CI, 1.198-6.884]), were significantly associated with OS . In multivariate analysis, surgical treatment with curative purpose was defined as a solo independent prognostic factor for OS (p = 0.03, HR = 9 [95% CI, 2.05-16.88]).


BTC remain diagnosed in Tunisia at locally advanced and/or metastatic stages impairing the prognosis. For the rare early cases, our results provide novel evidence that surgical treatment with curative purpose is an independent survival factor for BTC patients.

Clinical trial indentification

Legal entity responsible for the study

Abderahman Mami Hospital


Abderahman Mami Hospital


All authors have declared no conflicts of interest.