The combination of cisplatin and gemcitabine is the standard first-line treatment of metastatic biliary tract cancer (BTC) patients. The benefit of second-line chemotherapy in these patients is controversial. This study aims to evaluate the activity of FOLFIRI (fluorouracil and irinotecan) after failure to the first-line platinum and gemcitabine-based chemotherapy in metastatic BTC patients. We present a single-institution, retrospective cohort study. Patients with locally advanced or metastatic BTC who progressed after at least one line of chemotherapy, consecutively treated at our Institution between 2007 and 2017 were included. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), clinical benefit rate (CBR) and safety profile of FOLFIRI. Twelve patients were included in the analysis, with a median follow up of 5 months (95% CI 2.77-7.20). The median number of cycles received was 3 (range 1 to 9). Four grade 3 toxicities were recorded; no grade 4 toxicities and no treatment-related deaths occurred. The median PFS was 1.7 months (95% CI; 0.66-2.67), and median OS was 5 months (95% CI; 2.77-7.20). Two patients presented stable disease, providing a CBR of 17%. We concluded that FOLFIRI presented a favorable toxicity profile and a modest activity in metastatic BTC patients who had progressed to platinum and gemcitabine and may be considered in patients who are able to tolerate additional lines of chemotherapy. Immunotherapy and targeted therapies selected according to the tumoral genomic profile are promising alternatives to improve the outcomes of second-line treatment in BTC.

Background: the hepatitis B virus infection remains a major public health problem worldwide. It can lead to a liver cirrhosis and/or hepatocellular carcinoma. The World Health Organisation (WHO) has recommended the implementation of generalised vaccination programs against hepatitis B. In Cameroon, this vaccine was introduced in the expanded program on immunization (EPI) in 2005, but few studies have assessed the immune response. Objective: the general objective of this study was to identify factors associated with antibody levels among children aged from 15 to 59 months vaccinated against hepatitis B during the EPI in Cameroon. Method: this was a crosssectional study carried out from December 2021 to June 2022 in a paediatric centre of Yaoundé (Cameroon). We analysed the antibody level in children vaccinated against hepatitis B within the framework of the EPI. We enrolled children who had received a series of 3 intramuscular doses of hepatitis B vaccine at 6, 10 and 14 weeks after birth. Some children could receive a 4 th booster dose between 12 months. The antibody level was assessed by measuring the anti-HBs in such children, aged 15 -59 months. A good immunization was defined as a serum level of anti-HBs antibody level above 100 IU/mL; a poor immunization, for an anti-HBs antibody level between 10 and 100 IU/mL; and a non-immunization, for an anti-HBs antibody level < 10 IU/mL.

Introduction: General anesthesia and antisepsis have made intraperitoneal surgery safer. With the improvement of anesthetic techniques and the development of new surgical approaches, the liver, an organ with high haemorrhagic risks, has become the subject of many successful therapeutic indications. Although widely performed in high-income settings due to a better technical platform, the reverse is true for low-resource settings in Africa where there is little or no report on the anesthetic management of this dreadful surgery. Hence, this study is one of the first from Africa to report on the perioperative anesthetic management and outcome of hepatic resections. Methods: This was a retrospective case series study conducted over four years (2019-2022) through a chart review of all medical and anesthesia records of patients admitted to Douala General Hospital, Cameroon for hepatic resection. We collected socio-demographic, clinical, laboratory and intraoperative data, the estimated financial cost and patient outcomes. Results: Twelve open hepatic resections were performed mainly electively (11/12 cases) for localized hepatic tumours (7/12 cases) on ASA II patients (11/12 cases) with a mean age of 36.5 years and sex ratio of 1.2. Pre-anesthetic consultations were usually done within 24 days before the surgery. General anesthesia maintained with sevoflurane was the mainstay anesthetic technic. Continuous hemodynamic monitoring with an arterial catheter was done. The blood-sparing strategy was based on tranexamic acid, calcium gluconate and controlled hypotension with an How to cite this paper: Ndom Ntock, F.,

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