El-Shakankery Karim Hussien, Kefas Joanna, Andaleeb Ramis, Muehlschlegel Paula, Bridgewater John
Department of Medical Oncology, University College London Hospital, London NW1 2BU, UK.
University College London Cancer Institute, London WC1E 6DD, UK.
Cancers (Basel). 2025 May 12;17(10):1639. doi: 10.3390/cancers17101639.
: Bone metastasis (BM) prevalence is underreported in biliary tract cancers (BTC). This study aimed to assess BM prevalence in a real-world BTC population, alongside examining its relationship to prognosis and genomic alterations. : Patients with histology-proven BTC as reviewed at a university cancer centre between January 2019 and August 2022 were assessed. Data extracted from records included BTC subtype, molecular profiling and systemic anti-cancer therapy (SACT) use. Stratification by BTC subtype and metastasis sites occurred. Median overall survival (mOS) was defined as time from relapse or metastases to death. Survival analysis was conducted using the Cox Proportional Hazard model. : Of 197 patients, 74 (37.6%) had intrahepatic and 67 (34%) had extrahepatic cholangiocarcinoma. Thirty-four patients had BM (17.3%), with 14 identified at initial diagnosis. OS was not influenced by bone (HR 1.15; = 0.48) or liver metastases (HR 1.09; = 0.6). Stratifying for age and gender, no significant difference in OS was observed. Actionable alterations were equally likely in patients with (52.4%) and without BM (58.5%). Age of BTC onset (<65 or ≥65) did not significantly influence prevalence of actionable alterations. Patients receiving matched, targeted SACT had a mOS of 29.9 months, compared to 13.3 months in those with actionable alterations but no SACT matching (HR 0.35; < 0.005). : In advanced BTC, BM do not affect OS. Across all cohorts, actionable alterations improved OS when treated with matched SACT.
骨转移（BM）在胆道癌（BTC）中的患病率报告不足。本研究旨在评估真实世界中BTC患者群体的BM患病率，并研究其与预后和基因组改变的关系。：对2019年1月至2022年8月在大学癌症中心接受复查的组织学确诊的BTC患者进行评估。从记录中提取的数据包括BTC亚型、分子谱分析和全身抗癌治疗（SACT）的使用情况。按BTC亚型和转移部位进行分层。中位总生存期（mOS）定义为从复发或转移到死亡的时间。使用Cox比例风险模型进行生存分析。：197例患者中，74例（37.6%）患有肝内胆管癌，67例（34%）患有肝外胆管癌。34例患者发生骨转移（17.3%），其中14例在初诊时被确诊。总生存期不受骨转移（风险比1.15；P = 0.48）或肝转移（风险比1.09；P = 0.6）的影响。按年龄和性别分层，总生存期无显著差异。有骨转移（52.4%）和无骨转移（58.5%）的患者出现可操作改变的可能性相同。BTC发病年龄（<65岁或≥65岁）对可操作改变的患病率无显著影响。接受匹配的靶向SACT治疗的患者中位总生存期为29.9个月，而有可操作改变但未接受SACT匹配的患者为13.3个月（风险比0.35；P < 0.005）。：在晚期BTC中，骨转移不影响总生存期。在所有队列中，当接受匹配的SACT治疗时，可操作改变可改善总生存期。
