A novel online prognostic tool to predict long-term survival after liver resection for intrahepatic cholangiocarcinoma: The "metro-ticket" paradigm.

Abstract

BACKGROUND:

The aim of the current study was to develop an online calculator to predict survival after liver resection for intrahepatic cholangiocarcinoma (ICC) based on the "metro-ticket" paradigm.

METHODS:

Between 1990 and 2016, patients who underwent liver resection for ICC were identified in an international multi-institutional database. The final multivariable model of survival was used to develop an online prognostic calculator of survival.

RESULTS:

Among 643 patients, actual 5-year overall survival (OS) after resection for ICC was 42.7%. On multivariable analysis, CA19-9 > 200 (hazard ratio (HR), 2.62; 95% CI, 2.01-3.42), sum of the number and largest tumor size >7 (HR, 1.88; 95% CI, 1.46-2.42), N1 disease (HR, 2.87; 95% CI, 1.98-4.16), R1 resection (HR, 1.72; 95% CI, 1.21-2.46), poor/undifferentiated tumor grade (HR, 1.74; 95% CI, 1.25-2.44), major vascular invasion (HR, 1.47; 95% CI, 1.03-2.10), and adjuvant chemotherapy (HR, 0.64; 95% CI, 0.45-0.89) were significantly associated with survival and were included in the online calculator. The predictive accuracy of the model was good to very good as the C-statistics to predict 5-year OS was 0.696 in the training dataset and 0.672 with bootstrapping resamples (n = 5000) in the test dataset.

CONCLUSION:

A novel, online calculator was developed to estimate the 5-year survival probability for patients undergoing resection for ICC. This tool could help provide useful information to guide treatment decision-making and inform conversations about prognosis.

• Authors: Kota Sahara, Diamantis I Tsilimigras, Rittal Mehta, Fabio Bagante, Alfredo Guglielmi, Luca Aldrighetti, Sorin Alexandrescu, Hugo P Marques, Feng Shen, Bas G Koerkamp, Itaru Endo, Timothy M Pawlik
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 120 Issue 2 Pg. 223-230 (Aug 2019) ISSN: 1096-9098 [Electronic] United States
• PMID: 31004365 (Publication Type: Journal Article)
• Copyright: © 2019 Wiley Periodicals, Inc.

Topics

• Aged
• Bile Duct Neoplasms (mortality, surgery)
• Bile Ducts, Intrahepatic
• Cholangiocarcinoma (mortality, surgery)
• Female
• Hepatectomy
• Humans
• Male
• Middle Aged
• Online Systems
• Predictive Value of Tests
• Prognosis
• Survival Rate