Purpose: Prognostic factors for patients with advanced biliary tract cancer receiving chemotherapy are presently not well established. Gallbladder cancer and intra-hepatic cholangiocarcinoma are previously reported prognostic factors of poor prognosis; however, tumor volume has not been analyzed in these previous reports.
Methods: We analyzed 56 consecutive patients with advanced biliary tract cancer who had received gemcitabine and S-1 combination chemotherapy as first-line palliative chemotherapy. Prognostic factors, including the baseline sum longest diameter (BSLD) representing tumor volume in Response Evaluation Criteria in Solid Tumor, were evaluated.
Results: By multivariate analysis, age ≥70 (HR 3.01, 95% CI 1.25-7.31, P = 0.014) and larger BSLD (HR 1.09, 95% CI 1.01-1.18, P = 0.021) were statistically significant independent predictors of poor prognosis. Primary biliary site was not identified as a prognostic factor (P = 0.728). Median survival times of patients with BSLDs ≤ 9.0 cm and BSLDs > 9.0 cm were 18.7 and 8.8 months, respectively (P = 0.024).
Conclusions: Age and BSLD were identified as strong prognostic factors for patients with advanced biliary tract cancer receiving chemotherapy. Tumor volume might be more important than primary biliary site for the prognosis of advanced biliary tract cancer.