Clinicopathologic Characteristics and Survival Outcomes of Gallbladder and Biliary Tract Cancers: A 21-Year Single-Center Retrospective Cohort in Northern Iran

Danial Fazilat-panah; Seyed Reza Najafi; Hoda Shirafkan; Nima Noori; Fahime Khoshparast; Alireza Taji

doi:10.31557/APJCC.2026.11.5.661

Authors

Danial Fazilat-panah Assistant Professor of Radiation Oncology, Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran. https://orcid.org/0000-0003-4194-6575
Seyed Reza Najafi Bachelor’s Degree in Radiotherapy, Student Research and Technology Committee, Babol University of Medical Sciences, Babol, I.R. Iran.
Hoda Shirafkan Associate Professor of Biostatistics, Traditional Medicine and History of Medical Sciences Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran. https://orcid.org/0000-0002-5682-1153
Nima Noori Bachelor’s Degree in Radiotherapy, Student Research and Technology Committee, Babol University of Medical Sciences, Babol, I.R. Iran. https://orcid.org/0009-0006-9592-4004
Fahime Khoshparast Bachelor’s Degree in Radiotherapy, Student Research and Technology Committee, Babol University of Medical Sciences, Babol, I.R. Iran. https://orcid.org/0009-0008-2604-7022
Alireza Taji Assistant Professor of Radiation Oncology, Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran. https://orcid.org/0000-0002-6783-6940

DOI:

https://doi.org/10.31557/APJCC.2026.11.5.661

Keywords:

Gallbladder Cancer, Biliary Tract Cancer, Clinicopathological Characteristics, Survival Analysis, Tumor Grade, Prognostic Factors

Abstract

Introduction: Gallbladder cancer (GBC) and biliary tract cancers (BTC) are uncommon but aggressive malignancies often diagnosed at advanced stages and associated with poor survival. Their epidemiological patterns vary geographically, and long-term survival data from referral centers in Iran remain limited. This study aimed to evaluate clinicopathologic characteristics, survival outcomes, and identify independent prognostic factors in patients with GBC and BTC over a 21-year period in northern Iran.

Materials and Methods: This retrospective cohort included all patients diagnosed with primary GBC or BTC and treated at the Shahid Rajaee Radiotherapy Center, Babolsar, between 2004 and 2024. Demographic, clinical, and Pathologic variables were retrieved from medical records. Survival status was confirmed through telephone follow-up and civil registry verification. Kaplan– Meier analysis and log-rank tests were used to compare survival, while Cox proportional hazards regression identified predictors of mortality.

Results: A total of 63 patients met the eligibility criteria. The mean age was 58.16 ± 11.86 years, with nearly equal sex distribution. GBC accounted for 55.6% of cases. The overall survival and 1-, 2-, and 5-year survival rates were 38.1%, 81.0%, 61.9%, and 46.0%, respectively. The median overall survival was 20 months for GBC and 54 months for BTC (p=0.508). Higher tumor grades (Grade 3 and Grade 4) were associated with significantly increased hazard of death (all p≤0.002), whereas age, sex, histological subtype, and metastatic status did not independently predict mortality in multivariable analysis.

Conclusion: Tumor grade emerged as the strongest prognostic factor in GBC and BTC. multi-center studies with detailed staging and treatment data are needed to refine prognostic models.