Abstract 154P
Background
Biliary tract cancer (BTC) encompasses various subgroups: intrahepatic (iCCA), perihilar (pCCA), distal bile duct (dCCA), ampulla of Vater (AoV), and gallbladder cancers (GBC). The rising global incidence of BTC necessitates a thorough investigation into the unique features and outcomes of each anatomical location.
Methods
This retrospective study reviewed BTC patient demographics, risk factors, clinical presentation, treatment patterns, and prognosis by tumor location. Patients were diagnosed using ICD-10 codes C22-C24 from an electronic hospital database (2019-2022).
Results
A total of 553 patients were included, comprising 346 (64%) with iCCA, 100 (19%) with pCCA, 16 (4%) with dCCA, and 66 (13%) with GBC. Baseline characteristic, including median age (64), gender (M 62%), smoking history (23%), alcohol use history (29%), hepatitis B infection (3.4%), hepatitis C infection (1.8%) and comorbidities, were similar across all tumor locations. The proportion of localized/regional stage was highest in pCCA (70%), followed by AoV (62.5%), dCCA (50%), GBC (29%) and iCCA (25.6%). Jaundice was most common in pCCA (93%), followed by dCCA (88%), AoV (76%), iCCA (48%), and GBC (42%). Chemistry and tumor marker levels (CA19-9, CEA) were similar among the groups. The first treatment with surgery was achieved in 44% of AoV cases, 30% GBC cases, 12% iCCA cases, 4% pCCA cases and 0% in dCCA cases. The proportion of patients received no active anti-cancer treatment was highest in pCCA (95%), followed by dCCA (75%), AoV (76%) and iCCA (48%). The median overall survival (OS) was not reached in patients with AoV, compared to 12.8 months in GBC, 11.1 months in dCCA, 10.3 months in pCCA and 6.2 months ICCA. (P<0.05) Localized/regional stage, anatomical location, performance status, and receiving surgery were among the significant factors associated with improved OS.
Conclusions
Each location of BTC shows distinct stage distribution and treatment patterns, leading to different survival outcomes. Localized stage and surgical intervention are associated with better survival rates. Understanding the complexities of BTC subtypes is crucial for developing tailored treatment strategies and improving patient outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.