中国肿瘤外科杂志2025，Vol.17Issue(2)：173-176,4.DOI:10.3969/j.issn.1674-4136.2025.02.013
肝内胆管癌患者术后生存结局影响因素及预测模型构建
Factors affecting of postoperative survival outcomes and construction of a predictive model for patients with intrahepatic cholangiocarcinoma
摘要
Abstract
Objective To explore the factors affecting of the postoperative survival outcome of patients with intrahepatic cholangiocarcinoma(ICC),and to establish a nomographic model to verify the predictive value.Methods A retrospective analysis was performed on 110 ICC patients treated in the 904th Hospital of the PLA Joint Logistic Support Force from January 2018 to August 2021,all of whom underwent hepatectomy.The patients were followed up for 3 years after surgery.General data,tumor markers,TNM stage,tumor size,lymph node metastasis and other clinical data were collected.Multivariate Cox regression analysis was used to determine the main factors affecting postoperative prognosis of patients with intrahepatic cholangiocarcinoma(ICC),and a survival prediction nomogram model was constructed.The ROC curve and calibration curve were used to evaluate the discrimination and calibration degree of the model.Results The first,second and third year cumulative relapse-free survival rates were 43.01%,26.56%and 20.33%,respectively,and the median survival time was 14 months.The cumulative overall survival rates of 110 patients at the first,second and third years after surgery were 62.34%,41.78%and 27.63%,respectively.Multivariate analysis showed that age≥65 years old,high T stage,presence of lymph node metastasis,distant metastasis,and tumor diameter≥5 cm were all independent risk factors affecting survival rate and disease recurrence.The consistency index was 0.723(95%CI:0.662-0.790),and the AUC for the first,second and third year survival rates were 0.781(95%CI:0.678-0.871),0.841(95%CI:0.767-0.913),and 0.766(95%CI:0.671-0.862),respectively.Conclusions When developing individualized surgical plans for intrahepatic cholangiocarcinoma(ICC),it is essential to holistically evaluate tumor characteristics including multiplicity,dimensions,presence of vascular invasion,and involvement of adjacent organs.This comprehensive assessment forms the basis for selecting appropriate hepatectomy strategies,which is pivotal for optimizing patient prognosis and extending overall survival.The decision-making process should incorporate precise evaluation of tumor biology and anatomical relationships to ensure complete oncological resection while preserving adequate liver function.关键词
肝内胆管细胞癌/手术切除治疗/生存状况结果/预测影响因素模型Key words
Intrahepatic cholangiocarcinoma/Surgical resection and treatment/Outcome of survival status/Prediction of influencing factors model引用本文复制引用
王涛,谢伟选..肝内胆管癌患者术后生存结局影响因素及预测模型构建[J].中国肿瘤外科杂志,2025,17(2):173-176,4.基金项目
安徽医科大学校科研基金项目青年科学基金(2021xkj120) （2021xkj120）
