{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T09:24:53Z","timestamp":1793784293900,"version":"4.6.1"},"reference-count":0,"publisher":"The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS","issue":"6","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Turkish Journal of Medical Sciences"],"abstract":"<jats:p>Background\/aim: Biliary tract cancers (BTC) are relatively rare and have a poor prognosis in both localized and metastatic settings. Clinical trials tend to include patients who can tolerate treatments; however, chemotherapy eligibility, patterns, and survival may differ in the real world. The present study provides a 5-year overview of chemotherapy eligibility, patterns, tolerance, and survival in patients with resected and advanced BTCs.\nMaterials and methods:  Included in the study were patients with resectable or advanced BTC (excluding ampullary cancers) diagnosed between 2019 and 2024. The demographic\/clinical characteristics, chemotherapy eligibility, patterns, and survival outcomes of the patients were evaluated.\nResults: Of the 151 patients included in the study, 61 (40.7%) had resected BTC and 90 (59.3%) had advanced BTC. Among the patients with resected BTC, only 52.5% received adjuvant chemotherapy, 38.7% needed dose reductions, and 29% could not complete the planned cycles. Median recurrence-free survival and overall survival (OS) were 24.1 months (95% confidence interval (CI): 11.4\u201358.0) and 59 months (95% CI: 38.4\u201359) in patients with resected BTC, respectively, for all patients. In a multivariable analysis, only the number of adjuvant chemotherapy cycles was associated with OS [Hazard ratio (HR):0.63 (95% CI: 0.39\u20131.00), p=0.050]. Among the patients with advanced disease, 16.7% were not eligible for first-line chemotherapy, and 70.7% needed dose reduction. The median number of cycles was three (0-18); grade 3\u20134 adverse events were observed in 52% of the patients; and median progression-free survival and OS were 4.3 months (95% CI: 3.3\u20135.0) and 9.4 months (95% CI: 5.9\u201313.7) for all patients, respectively. Only 36.7% were able to receive second-line treatment. The number of first-line chemotherapy cycles [HR: 0.58 (95% CI: 0.45\u20130.76), p &lt; 0.001]\/discontinuation due to toxicity [HR: 3.26 (95% CI: 1.34\u20137.93), p = 0.009], cisplatin-gemcitabine regimen [HR: 0.10 (95% CI: 0.01\u20130.58), p&lt;0.001], and receiving second-line chemotherapy [HR: 0.28 (95% CI: 0.11\u20130.68), p &lt; 0.001] were significantly associated with OS in multivariable analyses.\nConclusion: This study shows that a significant proportion of patients with BTC are not eligible or intolerant to chemotherapy in the real world. Maintaining the planned treatment, even with dose reduction, is associated with better OS<\/jats:p>","DOI":"10.55730\/1300-0144.6102","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:15:13Z","timestamp":1766398513000},"page":"1445-1458","source":"Crossref","is-referenced-by-count":1,"title":["Chemotherapy tolerance and continuity are prognostic for overall survival in patients with localized and advanced biliary tract cancer"],"prefix":"10.55730","volume":"55","author":[{"given":"ERMAN","family":"AKKU\u015e","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PINAR","family":"KUB\u0130LAY TOLUNAY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EL\u0130F BERNA","family":"K\u00d6KSOY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HAT\u0130ME ARZU","family":"YA\u015eAR","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"34691","published-online":{"date-parts":[[2025,12,12]]},"container-title":["Turkish Journal of Medical Sciences"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T08:25:53Z","timestamp":1793780753000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.tubitak.gov.tr\/medical\/vol55\/iss6\/11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12,12]]}},"URL":"https:\/\/doi.org\/10.55730\/1300-0144.6102","relation":{},"ISSN":["1300-0144"],"issn-type":[{"value":"1300-0144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}