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


Journal

Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 01 04 2019
accepted: 04 04 2019
pubmed: 21 4 2019
medline: 20 7 2019
entrez: 21 4 2019
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 31004365
doi: 10.1002/jso.25480
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

223-230

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Kota Sahara (K)

Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio.
Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan.

Diamantis I Tsilimigras (DI)

Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio.

Rittal Mehta (R)

Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio.

Fabio Bagante (F)

Department of Surgery, University of Verona, Verona, Italy.

Alfredo Guglielmi (A)

Department of Surgery, University of Verona, Verona, Italy.

Luca Aldrighetti (L)

Department of Surgery, Ospedale San Raffaele, Milano, Italy.

Sorin Alexandrescu (S)

Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania.

Hugo P Marques (HP)

Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.

Feng Shen (F)

Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.

Bas G Koerkamp (BG)

Department of Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands.

Itaru Endo (I)

Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan.

Timothy M Pawlik (TM)

Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio.

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