Risk stratification system to predict recurrence of intrahepatic cholangiocarcinoma after hepatic resection.
BACKGROUND
Previous nomograms for intrahepatic cholangiocarcinoma (ICC) were conducted to predict overall survival, which could be influenced by various factors. Herein, we conducted our nomogram to predict recurrence of the tumor only after hepatic resection.


METHODS
The nomogram was established with prognostic factors for the relapse-free survival (RFS) analyzed from our single center cohort and was evaluated by comparing with the American Joint Committee on Cancer (AJCC) staging system for the predictive accuracy.


RESULTS
Seropositivity of hepatitis B surface antigen (hazard ratio [HR], 0.505; 95% confidence interval [CI], 0.279 to 0.914; P = 0.024), tumor size of larger than 5 cm (HR, 1.947; 95% CI, 1.177 to 3.219; P = 0.009), Child-Pugh score of B (HR, 3.067; 95% CI, 1.293 to 7.275; P = 0.011), and lymph node metastasis (HR, 2.790; 95% CI, 1.628 to 4.781; P < 0.001) were found to be independent prognostic factors that significantly affected RFS. The calibration curve for the prediction revealed excellent agreement between estimation by our stratification system and actual RFS. The concordance C index of the nomogram (0.71; 95% CI, 0.65 to 0.77) revealed to be significantly higher than the AJCC staging system (0.66; 95% CI, 0.60 to 0.72). In the validation cohort, our risk stratification system (C-index 0.65; 95% CI, 0.59 to 0.71) also revealed more precise prediction than the AJCC staging system (C-index, 0.57; 95% CI, 0.50 to 0.64).


CONCLUSIONS
Our nomogram could more accurately predict recurrence of ICC after hepatic resection than the AJCC staging system.
['Jeong|Seogsong|S|', 'Cheng|Qingbao|Q|', 'Huang|Lifeng|L|', 'Wang|Jian|J|', 'Sha|Meng|M|', 'Tong|Ying|Y|', 'Xia|Lei|L|', 'Han|Longzhi|L|', 'Xi|Zhifeng|Z|', 'Zhang|Jianjun|J|', 'Kong|Xiaoni|X|', 'Gu|Jinyang|J|', 'Xia|Qiang|Q|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001650:Bile Duct Neoplasms D018281:Cholangiocarcinoma D005260:Female D006498:Hepatectomy D006801:Humans D008297:Male D008875:Middle Aged D060787:Neoplasm Grading D009364:Neoplasm Recurrence, Local D009367:Neoplasm Staging D049451:Nomograms D011379:Prognosis D015203:Reproducibility of Results D018570:Risk Assessment D047368:Tumor Burden
Risk stratification Hepatic resection Nomogram Staging system Hepatitis B virus-associated intrahepatic cholangiocarcinoma