World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://www.wjon.org

Original Article

Volume 15, Number 3, June 2024, pages 405-413

Therapeutic Outcome of Multidisciplinary Treatment in Unresectable Biliary Tract Cancer: A Multicenter Retrospective Analysis

Figure 1. Overall survival stratified according to primary tumor location. MST: median survival time; IHCC: intrahepatic cholangiocarcinoma; GB: gallbladder cancer; yr: year; mo: months.

Figure 2. Overall survival stratified according to reason for unresectability. MST: median survival time; LN: lymph node; yr: year; mo: months.

Figure 3. Overall survival stratified according to treatment. MST: median survival time; yr: year; mo: months.

Figure 4. Overall survival stratified according to number of regimens. MST: median survival time; yr: year; mo: months; 5-FU: 5-fluorouracil.

**Table 1.** Patients’ Characteristics According to Tumor Location
Variable	IHCC (N = 74)	Hilar (N = 140)	Distal (N = 20)	GB (N = 81)	P value
Chi-squared and Fisher’s exact test (^aKruskal Wallis test). IHCC: intrahepatic cholangiocarcinoma; Hilar: hilar cholangiocarcinoma; Distal: distal bile duct cancer; LN: lymph node; GB: gallbladder cancer.
Age (years), median (range)	66 (37 - 82)	70 (39 - 92)	71 (38 - 85)	70 (40 - 82)	0.063^a
TNM classification
cT4, n (%)	49 (66.2)	90 (64.3)	13 (65)	68 (84)	< 0.001
cN1, n (%)	56 (75.7)	91 (65)	17 (85)	77 (95.1)	< 0.001
cM1, n (%)	42 (56.8)	49 (35)	13 (65)	56 (69.1)	0.011
Reasons for unresectability, n (%)
Locally advanced	21 (28.4)	54 (38.6)	6 (30.0)	20 (24.7)	0.171
Paraaortic LN metastases	10 (13.5)	13 (9.3)	5 (25.0)	17 (21.0)	0.012
Hematogenous metastases	21 (28.4)	28 (20.0)	4 (20.0)	27 (33.3)	0.183
Peritoneal dissemination	9 (12.2)	9 (6.4)	1 (5.0)	11 (13.6)	0.076
Patients’ condition	13 (17.5)	36 (25.7)	4 (20.0)	6 (7.4)	0.020
Jaundice, n (%)
Present	38 (51.4)	115 (82.1)	16 (80.0)	53 (65.4)	< 0.001
Absent	36 (48.6)	25 (17.9)	4 (20.0)	28 (34.6)
Biliary drainage, n (%)
Presents	48 (64.9)	133 (95.0)	19 (95.0)	67 (82.7)	< 0.001
Absent	26 (35.1)	7 (5.0)	1 (5.0)	14 (17.3)
Treatment, n (%)
Chemotherapy alone	46 (62.2)	48 (34.3)	14 (70.0)	46 (56.8)	< 0.001
Radiation alone	4 (5.4)	14 (10.0)	1 (5.0)	2 (2.5)	0.165
Chemoradiation	7 (9.5)	28 (20.0)	2 (10.0)	6 (7.4)	0.031
Best supportive care	17 (23.0)	50 (35.7)	3 (15.0)	27 (33.3)	< 0.001

Table 1. Patients’ Characteristics According to Tumor Location

Variable

IHCC (N = 74)

Hilar (N = 140)

Distal (N = 20)

GB (N = 81)

P value

Chi-squared and Fisher’s exact test (^aKruskal Wallis test). IHCC: intrahepatic cholangiocarcinoma; Hilar: hilar cholangiocarcinoma; Distal: distal bile duct cancer; LN: lymph node; GB: gallbladder cancer.

Age (years), median (range)

66 (37 - 82)

70 (39 - 92)

71 (38 - 85)

70 (40 - 82)

0.063^a

TNM classification

cT4, n (%)

49 (66.2)

90 (64.3)

13 (65)

68 (84)

< 0.001

cN1, n (%)

56 (75.7)

91 (65)

17 (85)

77 (95.1)

< 0.001

cM1, n (%)

42 (56.8)

49 (35)

13 (65)

56 (69.1)

0.011

Reasons for unresectability, n (%)

Locally advanced

21 (28.4)

54 (38.6)

6 (30.0)

20 (24.7)

0.171

Paraaortic LN metastases

10 (13.5)

13 (9.3)

5 (25.0)

17 (21.0)

0.012

Hematogenous metastases

21 (28.4)

28 (20.0)

4 (20.0)

27 (33.3)

0.183

Peritoneal dissemination

9 (12.2)

9 (6.4)

1 (5.0)

11 (13.6)

0.076

Patients’ condition

13 (17.5)

36 (25.7)

4 (20.0)

6 (7.4)

0.020

Jaundice, n (%)

Present

38 (51.4)

115 (82.1)

16 (80.0)

53 (65.4)

< 0.001

Absent

36 (48.6)

25 (17.9)

4 (20.0)

28 (34.6)

Biliary drainage, n (%)

Presents

48 (64.9)

133 (95.0)

19 (95.0)

67 (82.7)

< 0.001

Absent

26 (35.1)

7 (5.0)

1 (5.0)

14 (17.3)

Treatment, n (%)

Chemotherapy alone

46 (62.2)

48 (34.3)

14 (70.0)

46 (56.8)

< 0.001

Radiation alone

4 (5.4)

14 (10.0)

1 (5.0)

2 (2.5)

0.165

Chemoradiation

7 (9.5)

28 (20.0)

2 (10.0)

6 (7.4)

0.031

Best supportive care

17 (23.0)

50 (35.7)

3 (15.0)

27 (33.3)

< 0.001

**Table 2.** Details of Chemotherapy
Line of chemotherapy	First (n = 198)	Second (n = 68)	Third (n = 19)
GEM: gemcitabine monotherapy; 5-FU: 5-fluorouracil.
GEM alone	78 (39.4%)	15 (22.1%)	5 (26.3%)
GEM combination	45 (22.7%)	24 (35.3%)	4 (21.1%)
S-1 alone	23 (11.6%)	20 (29.4%)	4 (21.1%)
5-FU based	40 (20.2%)	4 (5.9%)	0
Others	12 (6.1%)	5 (7.4%)	6 (31.6%)

Table 2. Details of Chemotherapy

Line of chemotherapy

First (n = 198)

Second (n = 68)

Third (n = 19)

GEM: gemcitabine monotherapy; 5-FU: 5-fluorouracil.

GEM alone

78 (39.4%)

15 (22.1%)

5 (26.3%)

GEM combination

45 (22.7%)

24 (35.3%)

4 (21.1%)

S-1 alone

23 (11.6%)

20 (29.4%)

4 (21.1%)

5-FU based

40 (20.2%)

4 (5.9%)

Others

12 (6.1%)

5 (7.4%)

6 (31.6%)