The impact of age and comorbidity in advanced or recurrent biliary tract cancer receiving palliative chemotherapy

Naminatsu Takahara, Yousuke Nakai, Kei Saito, Takashi Sasaki, Yukari Suzuki, Akiyuki Inokuma, Hiroki Oyama, Sachiko Kanai, Tatsunori Suzuki, Tatsuya Sato, Ryunosuke Hakuta, Kazunaga Ishigaki, Tomotaka Saito, Tsuyoshi Hamada, Suguru Mizuno, Hirofumi Kogure, Minoru Tada, Hiroyuki Isayama, Kazuhiko Koike

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background and Aim: Limited data are available on age and comorbidity assessment in patients with biliary tract cancer (BTC). This study aimed to evaluate the association of age and comorbidity burden with clinical outcomes of chemotherapy for BTC. Methods: Consecutive 197 BTC patients undergoing first-line chemotherapy between 2007 and 2017 were retrospectively studied. Patients were classified to three groups according to the age-adjusted Charlson comorbidity index (ACCI) excluding the score about BTC and progression-free survival, overall survival (OS), and safety were compared. Results: Fifty-one patients (26%) were elderly (≥ 75 years), and ACCI was 0–2 in 73 patients (37%), 3–4 in 98 (50%), and ≥ 5 in 26 (13%). ACCI was associated with the administration of first-line combination chemotherapy (89% in 0–2, 80% in 3–4, and 64% in ≥ 5, P < 0.01) and second-line chemotherapy (67% in 0–2, 51% in 3–4, and 35% in ≥ 5, P = 0.01). ACCI was prognostic for OS in addition to performance status, disease status, and CA19-9: The hazard ratios in ACCI of 3–4 and ≥ 5 were 1.39 and 1.79, compared with ACCI of 0–2 (P = 0.04). While overall safety profile did not differ by ACCI, higher ACCI score group developed Grade 3–4 neutropenia more frequently (26% in 0–2, 42% in 3–4, and 46% in ≥ 5, P = 0.04). Conclusion: Age and comorbidity burden did affect OS and safety profile in BTC patients undergoing first-line palliative chemotherapy. ACCI can be a simple and useful tool to evaluate the age and comorbidity burden in these patients.

Original languageEnglish
Pages (from-to)1828-1835
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number10
Publication statusPublished - 1 Oct 2020
Externally publishedYes


  • age-adjusted Charlson comorbidity index
  • biliary tract cancer
  • chemotherapy
  • comorbidity


Dive into the research topics of 'The impact of age and comorbidity in advanced or recurrent biliary tract cancer receiving palliative chemotherapy'. Together they form a unique fingerprint.

Cite this