Clinical characteristics, treatment pattern and survival of patients with biliary tract cancer: A five-year retrospective cohort study at Tikur Anbessa Specialized Hospital, Ethiopia.
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Date
2025
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Addis Ababa Uinverstiy
Abstract
Biliary tract cancers (BTCs); including intrahepatic and extrahepatic
cholangiocarcinoma and gallbladder cancer—are rare but aggressive malignancies with rising
global incidence and mortality. In low- and middle-income countries like Ethiopia, biliary tract
cancer often presents at an advanced stage contributing to poor outcomes. To date, no published
studies in Ethiopia have investigated treatment patterns and survival outcomes for biliary tract
cancer patients
Objectives: This study aims to investigated the clinical characteristics, treatment patterns and
survival of biliary tract cancer patients at Tikur Anbessa Specialized Hospital from January 01,
2020 to September 01, 2025 in Addis Ababa; Ethiopia.
Methods: A retrospective cohort study was conducted by reviewing medical records of adult
patients diagnosed with biliary tract cancer from January 1, 2020 and September 01,2025. Data on
demographics, clinical characteristics, treatment modalities (surgery, radiotherapy,
chemotherapy), and survival was collected using standardized data collection tools. All data was
analyzed by using SPSS version 25. Descriptive statistics was used to describe demography,
clinical characteristics ,treatment modalities and survival pattern. Survival was estimated using
Kaplan-Meier analysis. Uni-variant was performed to identify association of predictive factors
(patient, disease and treatment related) with survival.
Results: A total of 50 patient were analyzed; the median age of diagnosis was 55.61years old with
SD±12.77. Female patient accounted 56%. About 38% of the patient had underlying comorbidities,
70% of the patient presented with abdominal pain, in 90% of the patient diagnosis was made with
tissue confirmation, 54% the patient had elevated CA19.9. CT scan was done for most of the
patients. The most common site was gallbladder cancer accounting 44%, 68% presented with
metastasis and the rest were locally advanced and adenocarcinoma was the frequent histologic
type(68%). Surgery was done for 17 patients and of this 6patient achieved complete resection. The
most common first line systemic therapy was chemotherapy in 82% with cisplatin plus
gemcitabine. About 22%(11) patient were found to have progressive disease following any first
line therapy and 7 patients started second line systemic therapy with FOLFOX. By the time of
data analysis about 70% patient were died with median overall survival of 6 month (95% CI, 4.85-
7.14 months),and 1- 2-, and 3-year overall survival of 28.6%, 11.4% and 2.9% respectively. Patient
with underlying medical illness(Hypertension), first line chemotherapy with cisplatin plus
gemcitabine who completed or received 6cyce and who achieved partial response had better
median and overall survival.
Conclusions: The survival outcomes of biliary tract cancer patients was very poor. Doublet
chemotherapy is the commonest patterns of treatment. Being hypertensive and receiving 6 cycles
of doublet systemic chemotherapy were associated with improved survival
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Keywords
Biliary Tract Cancer, Overall survival