Background: Biliary tract cancers (BTC) are uncommon malignancies and are underrepresented in the literature. Methods: We performed a retrospective population-based review of adult patients with biopsy-confirmed BTC in Alberta from 2000 to 2015. Demographic data, risk factors, symptoms, treatment, and staging data were collected and analyzed. Survival analyses were completed. Results: A total of 1604 patients were included in our study, of which 766 (47.8%) were male. The median age at diagnosis was 68 (range 19-99). There were 374 (23.3%) patients with resectable tumors at diagnosis versus 597 (37.2%) with unresectable tumors. Of the patients, 380 (21.5%) received chemotherapy (CT) and 81 (5.0%) underwent radiation therapy. There was a clear trend with worsening stage and performance status associated with shorter median overall survival (OS). Ampulla of Vater tumors had the best median OS (25.69 months), while intrahepatic bile duct cancers had the worst (5.78 months). First-line palliative CT regimens included gemcitabine+cisplatin (OS 14.98 months (mo), n = 212), single agent gemcitabine (OS 12.42 mo, n = 22), capecitabine (OS 8.12 mo, n = 8), and capecitabine+gemcitabine (OS 6.93 mo, n = 13). Patients with advanced or metastatic disease who received first-line gemcitabine+cisplatin had a median OS of 11.8 months (n = 119). Conclusion: BTCs have poor survival. Worse outcomes occur in higher stage and poorer Eastern Cooperative Oncology Group (ECOG) performance status patients across all tumor subtypes. Tumor resectability at diagnosis was associated with better OS. Our study supports the use of gemcitabine+cisplatin as a combination first-line palliative CT, as patients treated in Alberta have a comparable OS to that reported in the ABC-02 phase III study.

中文翻译：

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加拿大艾伯塔省胆道癌的基于人群的回顾性研究

背景：胆道癌 (BTC) 是一种罕见的恶性肿瘤，在文献中代表性不足。方法：我们对 2000 年至 2015 年阿尔伯塔省活检确诊 BTC 的成年患者进行了基于人群的回顾性研究。收集和分析了人口统计学数据、危险因素、症状、治疗和分期数据。完成了生存分析。结果：我们的研究共纳入了 1604 名患者，其中 766 名（47.8%）为男性。诊断时的中位年龄为 68 岁（范围 19-99）。诊断时有 374 名 (23.3%) 患者具有可切除的肿瘤，而 597 名 (37.2%) 患有不可切除的肿瘤。在这些患者中，380 名 (21.5%) 接受了化疗 (CT)，81 名 (5.0%) 接受了放射治疗。有一个明显的趋势，即分期和体能状态恶化与中位总生存期 (OS) 缩短相关。Vater 壶腹肿瘤的中位 OS 最佳（25.69 个月），而肝内胆管癌的中位 OS 最差（5.78 个月）。一线姑息性 CT 方案包括吉西他滨 + 顺铂（OS 14.98 个月（月），n = 212）、吉西他滨单药（OS 12.42 月，n = 22）、卡培他滨（OS 8.12 月，n = 8）和卡培他滨 +吉西他滨（OS 6.93 个月，n = 13）。接受一线吉西他滨+顺铂治疗的晚期或转移性疾病患者的中位 OS 为 11.8 个月（n = 119）。结论：BTC 的存活率很差。在所有肿瘤亚型中，较高分期和较差的东部肿瘤协作组 (ECOG) 体能状态患者的结果更糟。诊断时的肿瘤可切除性与更好的 OS 相关。我们的研究支持使用吉西他滨 + 顺铂作为联合一线姑息性 CT，