Development and Validation of a Nomogram Model to Predict the Prognosis of Intrahepatic Cholangiocarcinoma

Abstract

Background: The effective method for predicting prognosis of ICC is still lack. This study aims to establish and verify an effective prognostic nomogram model for intrahepatic cholangiocarcinoma (ICC) after partial hepatectomy. Materials and Methods: A nomogram model was developed in a cohort of 127 patients from January 2015 to December 2019. General clinical characteristics including preoperative physical examination data and postoperative pathological features were obtained. The independent risk factors identified by univariate and multivariate COX proportional hazards regression models were used to construct nomogram model. Predictive accuracy and discriminative ability were determined using a concordance index and a calibration curve. In addition, the clinical significance of postoperative pathological subtypes was analyzed by Kaplan-Meier survival analysis. Results: Univariate analysis and multivariate COX regression analysis revealed that CEA, maximum diameter, tumor number, and large duct type ICC was the independent risk factors. These variables were incorporated into the nomogram and the C-index for one year and three year overall survival prediction was 0.765 (95% CI: 0.672–0.814) and 0.695 (95% CI: 0.672–0.814), respectively. Postoperative pathological analysis showed that the large duct ICC had a distinct clinicopathological features and poor outcome. Conclusion: The proposed nomogram enables a prognostic prediction for patients with ICC and postoperative subclassification of ICC is of great significant to the prognosis of ICC.