and 33.3%; p ¼ 0.9). 23.4% of patients received second line treatment. The two most commonly used regimens were FOLFIRI (36.4%) and Capecitabine (27.3%). FOLFIRI seemed to be more effective than Capecitabine (respectively 66.7% of progression vs 100%, p ¼ 0.5). Only 4.3% of patients received a third line chemotherapy based on capecitabine or FOLFIRI. All patients progressed. The median number of received chemotherapy cycles was 4. 41.9% of our patients developed grade 3-4 toxicity during chemotherapy. There was no treatment-related death. Median overall survival (OS) and progression free survival (PFS) were respectively 6 and 5 months. On univariate analysis, factors associated with poor OS were elevated tumor markers (p ¼ 0.001), hepatic metastases (p ¼ 0.003) and radiologic progression after first line treatment (p ¼ 0.03). Those related with a better survival were receiving first (p<0.001) and second line chemotherapy (p ¼ 0.01) and having a surgery (p ¼ 0.01) even with a palliative intent (p ¼ 0.04). Multivariate analysis demonstrated that the only independent factor positively impacting on survival was receiving chemotherapy (p ¼ 0.01). Conclusion: Metastatic spread of gastric cancer is fatal. This study confirms the survival benefit and manageable toxicity of palliative chemotherapy but survival increase remains poor compared to improvements in other gastrointestinal cancers.

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GEMCITABINE in monotherapy because of performance status (2-3) and/or unfitness to cisplatin, while 13% received gemcitabine combined with oxaliplatin(GEMOX). The objective response rate was 16%. After a median follow-up of 08 months: Overall survival was 7 months and progression-free survival was 2.5 months. Conclusion: Biliary tract cancers have a non-negligible incidence by being the fifth of digestive cancer. The poor prognosis of our patients is mainly related to the juxta-hepatic and para-pedicular situation of tumors and the difficulties of an early diagnosis. Conventional chemotherapy is still the mainstay treatment in the lack of new targeted therapies. Therefore, further research is needed to improve the outcome of patients.