Do recurrent and de novo metastatic biliary tract cancer patients have the same outcome on treatment

351 Background: Biliary tract cancers (BTCs) include cholangiocarcinoma, which refers to cancers arising in the intrahepatic, perihilar or distal biliary tree, ampulla of vater and gallbladder carcinoma. Even after complete surgical resection, a large number of BTC patients develop recurrence. Whether recurrence after surgery and de novo metastatic BTC should have comparable stratification in first-line palliative systemic therapy clinical studies is unknown. Methods: 480 patients who received palliative chemotherapy as first-line treatment for advanced BTC between January 1987 and May 2014 in Princess Margaret Cancer Centre, Toronto were reviewed. Probability of overall survival (OS) was estimated using the Kaplan-Meier method, and independent prognostic factors for OS were identified using the multivariable Cox proportional hazard model. Results: There were 171 recurrent and 309 de novo metastatic patients. Median age at diagnosis was 62 years, performance status<2; 436 (91%) patients, male; 262 (55%). ...