Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter Study
BackgroundRecurrence is the main cause of death in perihilar cholangiocarcinoma (pCCA) patients after surgery. Identifying patients with a high risk of recurrence is important for decision-making regarding neoadjuvant therapy to improve long-term outcomes.AimThe objective of this study was to develo...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.849053/full |
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| author | Zhi-Peng Liu Wei-Yue Chen Zi-Ran Wang Xing-Chao Liu Hai-Ning Fan Lei Xu Yu Pan Shi-Yun Zhong Dan Xie Jie Bai Yan Jiang Yan-Qi Zhang Hai-Su Dai Zhi-Yu Chen |
| author_facet | Zhi-Peng Liu Wei-Yue Chen Zi-Ran Wang Xing-Chao Liu Hai-Ning Fan Lei Xu Yu Pan Shi-Yun Zhong Dan Xie Jie Bai Yan Jiang Yan-Qi Zhang Hai-Su Dai Zhi-Yu Chen |
| author_sort | Zhi-Peng Liu |
| collection | DOAJ |
| description | BackgroundRecurrence is the main cause of death in perihilar cholangiocarcinoma (pCCA) patients after surgery. Identifying patients with a high risk of recurrence is important for decision-making regarding neoadjuvant therapy to improve long-term outcomes.AimThe objective of this study was to develop and validate a prognostic model to predict recurrence-free survival (RFS) after curative resection of pCCA.MethodsPatients following curative resection for pCCA from January 2008 to January 2016 were identified from a multicenter database. Using random assignment, 70% of patients were assigned to the training cohort, and the remaining 30% were assigned to the validation cohort. Independent predictors of RFS after curative resection for pCCA were identified and used to construct a prognostic model. The predictive performance of the model was assessed using calibration curves and the C-index.ResultsA total of 341 patients were included. The median overall survival (OS) was 22 months, and the median RFS was 14 months. Independent predictors associated with RFS included lymph node involvement, macrovascular invasion, microvascular invasion, maximum tumor size, tumor differentiation, and carbohydrate antigen 19-9. The model incorporating these factors to predict 1-year RFS demonstrated better calibration and better performance than the 8th American Joint Committee on Cancer (AJCC) staging system in both the training and validation cohorts (C-indexes: 0.723 vs. 0.641; 0.743 vs. 0.607).ConclusionsThe prognostic model could identify patients at high risk of recurrence for pCCA to inform patients and surgeons, help guide decision-making for postoperative adjuvant therapy, and improve survival. |
| first_indexed | 2024-04-14T00:27:12Z |
| format | Article |
| id | doaj.art-3073fe641bd74530a1fb8d96c92d3682 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-14T00:27:12Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-3073fe641bd74530a1fb8d96c92d36822022-12-22T02:22:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-04-011210.3389/fonc.2022.849053849053Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter StudyZhi-Peng Liu0Wei-Yue Chen1Zi-Ran Wang2Xing-Chao Liu3Hai-Ning Fan4Lei Xu5Yu Pan6Shi-Yun Zhong7Dan Xie8Jie Bai9Yan Jiang10Yan-Qi Zhang11Hai-Su Dai12Zhi-Yu Chen13Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Clinical Research Institute, Lishui Hospital of Zhejiang University, Lishui, ChinaDepartment of General Surgery, 903rd Hospital of People’s Liberation Army, Hangzhou, ChinaDepartment of Hepatobiliary Surgery, Sichuan Provincial People’s Hospital, Chengdu, ChinaDepartment of Hepatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Health Statistics, College of Military Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaBackgroundRecurrence is the main cause of death in perihilar cholangiocarcinoma (pCCA) patients after surgery. Identifying patients with a high risk of recurrence is important for decision-making regarding neoadjuvant therapy to improve long-term outcomes.AimThe objective of this study was to develop and validate a prognostic model to predict recurrence-free survival (RFS) after curative resection of pCCA.MethodsPatients following curative resection for pCCA from January 2008 to January 2016 were identified from a multicenter database. Using random assignment, 70% of patients were assigned to the training cohort, and the remaining 30% were assigned to the validation cohort. Independent predictors of RFS after curative resection for pCCA were identified and used to construct a prognostic model. The predictive performance of the model was assessed using calibration curves and the C-index.ResultsA total of 341 patients were included. The median overall survival (OS) was 22 months, and the median RFS was 14 months. Independent predictors associated with RFS included lymph node involvement, macrovascular invasion, microvascular invasion, maximum tumor size, tumor differentiation, and carbohydrate antigen 19-9. The model incorporating these factors to predict 1-year RFS demonstrated better calibration and better performance than the 8th American Joint Committee on Cancer (AJCC) staging system in both the training and validation cohorts (C-indexes: 0.723 vs. 0.641; 0.743 vs. 0.607).ConclusionsThe prognostic model could identify patients at high risk of recurrence for pCCA to inform patients and surgeons, help guide decision-making for postoperative adjuvant therapy, and improve survival.https://www.frontiersin.org/articles/10.3389/fonc.2022.849053/fullperihilar cholangiocarcinomaprognostic modelrecurrenceresectiononcology |
| spellingShingle | Zhi-Peng Liu Wei-Yue Chen Zi-Ran Wang Xing-Chao Liu Hai-Ning Fan Lei Xu Yu Pan Shi-Yun Zhong Dan Xie Jie Bai Yan Jiang Yan-Qi Zhang Hai-Su Dai Zhi-Yu Chen Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter Study Frontiers in Oncology perihilar cholangiocarcinoma prognostic model recurrence resection oncology |
| title | Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter Study |
| title_full | Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter Study |
| title_fullStr | Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter Study |
| title_full_unstemmed | Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter Study |
| title_short | Development and Validation of a Prognostic Model to Predict Recurrence-Free Survival After Curative Resection for Perihilar Cholangiocarcinoma: A Multicenter Study |
| title_sort | development and validation of a prognostic model to predict recurrence free survival after curative resection for perihilar cholangiocarcinoma a multicenter study |
| topic | perihilar cholangiocarcinoma prognostic model recurrence resection oncology |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.849053/full |
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