The impact of gender and immune system determinants on long-term survival in biliary tract cancer

Advanced biliary tract cancers are poor prognosis tumors with limited therapeutic options. The conven-tional treatment consists of combination chemotherapy resulting in overall survival of less than 12 months. Recently, a subgroup of patients characterized by an exceedingly fa-vorable prognosis has been reported in the literature. In our study, we assessed the prevalence and provided a clinico-pathological characterization of this subset of patients in the context of daily practice. In particular, we were able to identify female sex and neutrophil-to-lymphocyte ratio as independent predictors of long-term survival. Based on these premises, we deem it necessary to prompt transla-tional research projects aimed at molecularly characterized long-term survivors, particularly focusing on sex-and im-mune-related determinants.