外科理论与实践2024，Vol.29Issue(2)：170-178,9.DOI:10.16139/j.1007-9610.2024.02.13
基于肝内胆管癌预后模型筛选辅助化疗受益人群
Screening and identification of the beneficiaries of adjuvant chemotherapy based on the prognostic model of intra-hepatic cholangiocarcinoma
摘要
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).Conclusions 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.关键词
肝内胆管癌/列线图/辅助化疗/预后/多中心Key words
Intrahepatic cholangiocarcinoma(ICC)/Nomogram/Adjuvant chemotherapy/Prognosis/Multicenter分类
医药卫生引用本文复制引用
林起柱,刘红枝,黄霆峰,范瑞林,周伟平,郑树国,楼健颖,曾永毅..基于肝内胆管癌预后模型筛选辅助化疗受益人群[J].外科理论与实践,2024,29(2):170-178,9.基金项目
国家自然科学基金(62275050) （62275050）
福建省科技创新联合资金项目(2023Y9268) （2023Y9268）
福建省卫生健康委员会中青年科研重大项目(2021ZQNZD013) （2021ZQNZD013）
