Abstract
BackgroundOur objective was to identify risk factors affecting overall survival (OS) and cancer-specific survival (CSS) and build nomograms to predict survival based on a large population-based cohort.MethodsTwo hundred and thirty patients diagnosed with CHCC between 2004 and 2015 were retrospectively extracted from the Surveillance, Epidemiology, and End Results (SEER) database as a training cohort. In addition, Ninety-nine patients diagnosed with CHCC between 2000 and 2017 were retrospectively extracted from Sun Yat-Sen University Cancer Center (SYSUCC) as an external validation. Nomograms for predicting probability of OS and CSS were established. Performance of the nomograms was measured by concordance index (C-index) and the area under receiver operating characteristic (ROC) curve (AUC).ResultsIn training cohort, the 1-, 2 and 3-year OS were 67.7, 46.8 and 37.9%, and the 1-, 2 and 3-year CSS were 73.1, 52.0 and 43.0%, respectively. The established nomograms were well calibrated in both training and validation cohort, with concordance indexes (C-index) of 0.652 and 0.659, respectively for OS prediction; 0.706 and 0.763, respectively for CSS prediction. Nomograms also displayed better discriminatory compared with 8th edition tumor-node-metastasis (TNM) stage system for predicting OS and CSS.ConclusionWe constructed nomograms to predict OS and CSS based on a relatively large cohort. The established nomograms were well validated and could serve to improve predictions of survival risks and guide management of patients with CHCC after surgery.
Highlights
Our objective was to identify risk factors affecting overall survival (OS) and cancer-specific survival (CSS) and build nomograms to predict survival based on a large population-based cohort
Combined hepatocellular cholangiocarcinoma (CHCC) is a rare primary liver cancer, which is composed of mixed elements of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (ICC) [1] and accounts for only 0.4–14.5% of the primary liver cancer [2]
It was reported that the differences of clinical features among CHCC, HCC and ICC could lead to the variations of prognostic factors [12, 13]
Summary
Our objective was to identify risk factors affecting overall survival (OS) and cancer-specific survival (CSS) and build nomograms to predict survival based on a large population-based cohort. Regarding the treatment of CHCC, patients can obtain the best chance. He et al BMC Cancer (2019) 19:178 prognostic factors, such as tumor size, lymph node (LN) metastasis and distant metastasis. There was no a TNM stage system which is specially designed for CHCC. There were many factors, such as age, gender and tumor grade, which were shown to have great impact on survival. They were not included in the TNM stage system.
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