Abstract 241P
Background
Biliary tract cancers (BTC) present significant challenges in management due to their aggressive nature and often late-stage presentation. we present demographic trends, molecular characteristics, treatment patterns, and survival outcomes.
Methods
This retrospective study included patients diagnosed with BTC between March 2018 and December 2023. Survival analysis was done using the Kaplan-Meier analysis.
Results
Total of 508 patients were diagnosed with BTC, median age of the cohort was 61 years (IQR 52.2-69); with F: M ratio being 1.09:1. Distribution according to the stage at presentation was: stage I (n=10, 1.9%), stage II (n=20, 3.9%), Stage III (n=62, 12.2%) and stage IV (n=323, 63.5%). History of gallstones was reported in 122 patients (24%). Out of the total cohort, 287 patients (56.5%) had gallbladder cancers (GBCs) while 221 patients (43.5%) had cholangiocarcinoma (CCA), where (n=139) 62.9% were intrahepatic, (n=22) 9.9% were perihilar and (n=40) 18% were distal bile duct. Predominant histologic patterns among GBCs were: adenocarcinomas (n=221, 77%), small cell carcinomas (n=9,3.1%) adenosquamous (n-7, 2.4%), and others (n=50, 17.4%). Molecular testing could be done in 63 patients (12.4%%), out of which 8/63 (12.6%) had HER2 overexpression, 13/63 (20.6%) had TP53 mutation, while others were MSI-high (n=3), TMB-high (≥10 mut/Mb) (n=2), PDL1 positive (n=12), FGFR (n=2), IDH (n=1), BRCA2 (n=1). Treatment and survival outcomes were available for 339 patients, surgery was done in 71 patients (20.9%), palliative systemic therapy was done in 184(54.2%) patients while targeted or immunotherapy was used in 18 patients (5.3%). Median Overall survival (mOS) of the cohort was 21 months (17.9-24) with a median follow-up duration of 28 months. mOS for GBC was 20(16.6-23.4) months and CCA was 25(12.5-37.4) months. mOS for Metastatic BTC was 16 months while for Non-metastatic it was 50 months (p<0.001).
Conclusions
Management of BTC is marred with late-stage presentation, poor access to molecular testing and adept health care facilities in highly prevalent countries like India. Measures need to be taken to improve treatment outcomes in this malignancy.
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.