Screening and identification of the beneficiaries of adjuvant chemotherapy based on the prognostic model of intrahepatic cholangiocarcinoma

Abstract

Objective To establish and validate a Nomogram model for predicting the overall survival (OS) of the patients with intrahepatic cholangiocarcinoma (ICC) based on domestic multicenter data, and screen the beneficiaries of adjuvant chemotherapy based on the prediction model. Methods From December 2011 to December 2017, the data of 278 patients with postoperative pathological diagnosis of ICC from 4 medical centers in our country were collected retrospectively COX regression model was used to screen the independent risk factors of OS and constructed a Nomogram model. This model was used to stratify the risk of OS for all patients and to screen the beneficiaries of adjuvant chemotherapy. Results A total of 278 patients were enrolled, and 23 cases(8.3%) received adjuvant chemotherapy. COX multivariate analysis showed that drinking history, ECOG score, method of hepatectomy, lymph node status, number of tumors, and tumor differentiation were independent risk factors for postoperative OS. The Nomogram model had a C-index of 0.690(95% CI: 0.646-0.734) in the training cohort and 0.740(95% CI: 0.863-0.617) in the validation cohort. According to risk stratification by Nomogram model, in the high-risk group there was a statistically significant difference in survival between adjuvant chemotherapy and non-adjuvant chemotherapy (P=0.033), whereas in the low-risk group, there was no significant difference in survival(P=0.59). Conclusion Nomogram model based on independent risk factors of OS demonstrated excellent predictive capability for survival and could be used to screen, and identify the patients with ICC who benefit from adjuvant chemotherapy.

Keywords

• |intrahepatic cholangiocarcinoma(icc)|nomogram|adjuvant chemotherapy|prognosis|multicenter