Biliary tract cancers – single institution retrospective analysis, a cross-section of epidemiological data with treatment patterns and the outcomes of biliary tract cancers at The Department of Oncology and Radiotherapy, University Hospital Split fro

This study aimed to better understand the current epidemiology, treatment patterns, and outcomes of biliary tract cancers (BTC), and identify potential improvements in all aspects. We analyzed data from patients diagnosed with BTC in our clinic over 4 years (2019-2022). Among the 85 identified patients, 47.1% (n=40) were initially metastatic (M1). 60% (n=51) of patients had surgery, with curative intent for 45.9% (n=39) of patients. Among them, 50% were treated with adjuvant chemotherapy, and the remaining patients were followed up. We evaluated the disease-free survival (DFS) of the entire subset of patients with the M0 stage, regardless of the adjuvant treatment, and found a median DFS of 34 months. Out of 58 patients with M1 stage (68.2% of the entire cohort included in the analysis), 74.1% (n=43) of the patients received first-line systemic therapy (LOT1), and 25.9% (n=19) received best supportive care (BSC). We noticed a decrease in the number of patients with each subsequent LOT due to disease progression and deterioration of performance status (PS). The median OS of the entire cohort was 26.4 months; 22 months for the M1 stage and 61.6 months for the M0 stage. We confirmed that BTC is mostly diagnosed at an older age (median of 70 years) and in the advanced stage of the disease. Almost one-third of M1- stage patients never received any systemic anticancer therapy, highlighting the enormous unmet need. The value of targeted therapy based on precision medicine should be further investigated and potentially available to all patients with actionable mutations.