Oncotarget

Clinical Research Papers:

Establishment and validation of a prognostic nomogram for patients with resectable perihilar cholangiocarcinoma

Peizhan Chen _, Bin Li, Yan Zhu, Wei Chen, Xin Liu, Mian Li, Xiaohua Duan, Bin Yi, Jinghan Wang, Chen Liu, Xiangji Luo, Xiaoguang Li, Jingquan Li, Lijian Liang, Xiaoyu Yin, Hui Wang and Xiaoqing Jiang

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Oncotarget. 2016; 7:37319-37330. https://doi.org/10.18632/oncotarget.9104

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Abstract

Peizhan Chen1,*, Bin Li1,2,3,*, Yan Zhu4,*, Wei Chen5, Xin Liu5, Mian Li1, Xiaohua Duan1, Bin Yi2,3, Jinghan Wang6, Chen Liu2,3, Xiangji Luo2,3, Xiaoguang Li1, Jingquan Li1, Lijian Liang5, Xiaoyu Yin5, Hui Wang1,7,8, Xiaoqing Jiang2,3

1Key Laboratory of Food Safety Research, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, 200031, P. R. China

2Biliary Tract Surgery Department I, Eastern Hepatobiliary Surgery Hospital, Secondary Military Medical University, Shanghai, 200433, P. R. China

3Diagnosis and Treatment Center of Malignant Biliary Tract Diseases, Secondary Military Medical University, Shanghai, 200433, P. R. China

4Department of Pathology, Changhai Hospital, Secondary Military Medical University, Shanghai, 200433, P. R. China

5Department of Pancreatobiliary Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, 510080, P. R. China

6Department of Hepatobiliary Surgery, Navy General Hospital, 100048, P. R. China

7Key Laboratory of Food Safety Risk Assessment, Ministry of Health, Beijing, 100021, P. R. China

8School of Life Science and Technology, ShanghaiTech University, Shanghai, 200031, P. R. China

*These authors have contributed equally to this work

Correspondence to:

Xiaoqing Jiang, e-mail: [email protected]

Hui Wang, e-mail: [email protected]

Xiaoyu Yin, e-mail: [email protected]

Keywords: perihilar cholangiocarcinoma, overall survival, nomogram

Received: March 03, 2016    Accepted: April 13, 2016    Published: April 29, 2016

ABSTRACT

As the conventional staging systems have poor prognosis prediction ability for patients with perihilar cholangiocarcinoma (pCCA), we established and validated an effective prognostic nomogram for pCCA patients based on their personal and tumor characteristics. A total of 235 patients who received curative intent resections at the Eastern Hepatobiliary Surgery Hospital from 2000 to 2009 were recruited as the primary training cohort. Age, preoperative CA19-9 levels, portal vein involvement, hepatic artery invasion, lymph node metastases, and surgical treatment outcomes (R0 or R1/2) were independent prognostic factors for pCCA patients in the primary cohort as suggested by the multivariate analyses and these were included in the established nomogram. The calibration curve showed good agreement between overall survival probability of pCCA patients for the nomogram predictions and the actual observations and the concordance index (C-index) was 0.68 (95% CI, 0.61-0.71). The C-index values and time-dependent ROC tests suggested that the nomogram is superior to the conventional staging systems including the Bismuth-Corlette, Gazzaniga, Memorial Sloan Kettering Cancer Center (MSKCC), American Joint Committee on Cancer (AJCC) TNM 7th edition, and Mayo Clinic. The nomogram also performed better than the traditional staging system in the internal cohort with 93 pCCA patients from the same institution and an external validation cohort including 84 pCCA patients from another institution in predicting the overall survival of the pCCA patients as suggested by the C-index values and the time-dependent ROC tests. In summary, the proposed nomogram has superior predictive accuracy of prognosis for resectable pCCA patients.


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