The analysis of long-term prognostic factors after laparoscopic liver resection for intrahepatic cholangiocarcinoma and establishment of survival Nomogram model.
10.3760/cma.j.cn112139-20220413-00163
- Author:
Ze Feng SHEN
1
;
Chen CHEN
2
;
Zhi Min GENG
2
;
Xian Hai MAO
3
;
Jing Dong LI
4
;
Tian Qiang SONG
5
;
Chuan Dong SUN
6
;
Hong WU
7
;
Zhang Jun CHENG
8
;
Rui Xin LIN
9
;
Yu HE
10
;
Wen Long ZHAI
11
;
Di TANG
12
;
Zhao Hui TANG
13
;
Xiao LIANG
1
Author Information
1. Department of General Surgery,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310000,China.
2. Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China.
3. Department of Hepatobiliary Surgery,Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University),Changsha 410005,China.
4. Department of Hepatobiliary Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China.
5. Department of Hepatobiliary Oncology,Tianjin Medical University Cancer Hospital,Tianjin 300060,China.
6. Department of Hepatobiliary Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266000,China.
7. Department of Liver Surgery,West China Hospital of Sichuan University,Chengdu 610041,China.
8. Department of Hepatobiliary Surgery,Zhongda Hospital of Southeast University,Nanjing 210009,China.
9. Department of Hepatobiliary and Pancreatic Surgery,the Second Hospital of Jilin University,Changchun 130021,China.
10. Department of Hepatobiliary Surgery,the First Hospital Affiliated to Army Medical University,Chongqing 400038,China.
11. Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China.
12. Department of General Surgery,the Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen 518000,China.
13. Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
- Publication Type:Journal Article
- MeSH:
Bile Duct Neoplasms/surgery*;
Bile Ducts, Intrahepatic/pathology*;
CA-19-9 Antigen;
Cholangiocarcinoma/diagnosis*;
Female;
Humans;
Laparoscopy;
Lymphatic Metastasis;
Male;
Nomograms;
Prognosis;
Retrospective Studies
- From:
Chinese Journal of Surgery
2022;60(10):939-947
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To establish a survival prediction model based on the independent prognostic factors of long-term prognosis after laparoscopic liver resection(LLR) for intrahepatic cholangiocarcinoma(ICC). Methods: The clinical and pathological data of 351 consecutive patients with ICC who received radical LLR in 13 Chinese medical centers from August 2010 to May 2021 were collected retrospectively. There were 190 males and 161 females,aged(M(IQR)) 61(14)years(range:23 to 93 years). The total cohort was randomly divided into a training dataset(264 cases) and a validation dataset(87 cases). The patients were followed up by outpatient service or telephone,and the deadline for follow-up was October 2021. Based on the training dataset,the multivariate Cox proportional hazards regression model was used to screen the independent influencing factors of long-term prognosis to construct a Nomogram model. The Nomogram model's discrimination,calibration,and clinical benefit were evaluated through internal and external validation,and an assessment of the overall value of two groups was made through the use of a receiver operating characteristic(ROC) curve. Results: There was no significant difference in clinical and pathological characteristics and long-term survival results between the training and validation datasets(all P>0.05). The multivariate Cox analysis showed that CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis were independent prognostic factors for ICC patients after LLR(all P<0.05). The survival Nomogram was established based on the independent prognostic factors obtained from the above screening. The ROC curve showed that the area under the curve of 1, 3 and 5-year overall survival rates of patients in the training dataset were 0.794(95%CI:0.721 to 0.867),0.728(95%CI:0.618 to 0.839) and 0.799(95%CI:0.670 to 0.928),and those in the validation dataset were 0.787(95%CI:0.660 to 0.915),0.831(95%CI:0.678 to 0.983) and 0.810(95%CI:0.639 to 0.982). Internal and external validation proved that the model exhibited a certain discrimination,calibration,and clinical applicability. Conclusion: The survival Nomogram model based on the independent influencing factors of long-term prognosis after LLR for ICC(including CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis) exhibites a certain differentiation,calibration,and clinical practicability.
