A Nomogram in Predicting Risks of Intrahepatic Cholangiocarcinoma After Partial Hepatectomy for Hepatolithiasis

Shen, Hao; Zhang, Shichao; Xia, Yong; Chen, Can; Huo, Lei; Gan, Linhe; Li, Jun; Wang, Kui; Pawlik, Timothy M.; Lau, Wan Yee; Wu, Mengchao; Shen, Feng

doi:10.1007/s11605-021-04947-w

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…To avoid the influence of malignant tumors on the prognosis of patients with hepatolithiasis during the follow-up period, patients in the training and validation groups who showed ICC at the time of hospitalization were excluded (7.7%). Moreover, cancer was regarded as one of the long-term complications of hepatolithiasis in the follow-up, and was classified as a follow-up endpoint (15 patients, 3.4%), in agreement with previous studies[ 19 , 25 , 34 , 36 , 37 ].…”

Section: Discussionsupporting

confidence: 71%

“…A reduction or inversion of AGR, which also appears in cirrhosis and chronic hepatitis, indicates serious liver damage. A previous study indicated that elevated NLR is an independent risk factor for secondary intrahepatic cholangiocarcinoma (ICC) after surgery for hepatolithiasis[ 34 ], but the association between elevated NLR and ICC remains to be elucidated. Inflammation and subtle alterations in immune regulation may play important roles in this process[ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinical online nomogram for predicting prognosis in recurrent hepatolithiasis after biliary surgery: A multicenter, retrospective study

Tian¹,

Chen²,

Li³

et al. 2022

WJG

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BACKGROUND Methods for predicting the prognosis of patients undergoing surgery for recurrent hepatolithiasis after biliary surgery are currently lacking. AIM To establish a nomogram to predict the prognosis of patients with recurrent hepatolithiasis after biliary surgery. METHODS In this multicenter, retrospective study, data of consecutive patients in four large medical centers who underwent surgery for recurrent hepatolithiasis after biliary surgery were retrospectively analyzed. We constructed a nomogram to predict the prognosis of recurrent hepatolithiasis in a training cohort of 299 patients, following which we independently tested the nomogram in an external validation cohort of 142 patients. Finally, we used the concordance index (C-index), calibra-tion, area under curve, decision curve analysis, clinical impact curves, and visual fit indices to evaluate the accuracy of the nomogram. RESULTS Multiple previous surgeries [2 surgeries: Odds ratio (95% confidence interval), 1.451 (0.719-2.932); 3 surgeries: 4.573 (2.015-10.378); ≥ 4 surgeries: 5.741 (1.347-24.470)], bilateral hepatolithiasis [1.965 (1.039-3.717)], absence of immediate clearance [2.398 (1.304-4.409)], neutrophil-to-lymphocyte ratio ≥ 2.462 [1.915 (1.099-3.337)], and albumin-to-globulin ratio ≤ 1.5 [1.949 (1.056-3.595)] were found to be independent factors influencing the prognosis. The nomogram constructed on the basis of these variables showed good reliability in the training (C-index: 0.748) and validation (C-index: 0.743) cohorts. Compared with predictions using traditional classification models, those using our nomogram showed better agreement with actual observations in the calibration curve for the probability of endpoints and the receiver operating characteristic curve. Dichloroacetate and clinical impact curves showed a larger net benefit of the nomogram. CONCLUSION The nomogram developed in this study demonstrated superior performance and discriminative power compared to the three traditional classifications. It is easy to use, highly accurate, and shows excellent calibration.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Clinical online nomogram for predicting prognosis in recurrent hepatolithiasis after biliary surgery: A multicenter, retrospective study

Tian¹,

Chen²,

Li³

et al. 2022

WJG

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“…They then determine the incidence of the corresponding outcome based on the total score obtained and make treatment mode decisions accordingly. Nomograms have been repeatedly found to be applicable to ICC and they had better predictive value than the traditional grading system [ 36 , 37 ]. Therefore, we included HTS grade and other independent prognostic factors that were based on multivariate Cox regression analysis into our nomograms as well.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of HTS grade in patients with intrahepatic cholangiocarcinoma undergoing radical resection: a multicenter study from China

Huang,

Zhang,

Yang

et al. 2024

World J Surg Onc

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Background Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumor with a poor prognosis. This study aimed to investigate whether Hemoglobin, Albumin, Lymphocytes, and Platelets (HALP) score and Tumor Burden Score (TBS) serves as independent influencing factors following radical resection in patients with ICC. Furthermore, we sought to evaluate the predictive capacity of the combined HALP and TBS grade, referred to as HTS grade, and to develop a prognostic prediction model. Methods Clinical data for ICC patients who underwent radical resection were retrospectively analyzed. Univariate and multivariate Cox regression analyses were first used to find influencing factors of prognosis for ICC. Receiver operating characteristic (ROC) curves were then used to find the optimal cut-off values for HALP score and TBS and to compare the predictive ability of HALP, TBS, and HTS grade using the area under these curves (AUC). Nomogram prediction models were constructed and validated based on the results of the multivariate analysis. Results Among 423 patients, 234 (55.3%) were male and 202 (47.8) were aged ≥ 60 years. The cut-off value of HALP was found to be 37.1 and for TBS to be 6.3. Our univariate results showed that HALP, TBS, and HTS grade were prognostic factors of ICC patients (all P < 0.05), and ROC results showed that HTS had the best predictive value. The Kaplan–Meier curve showed that the prognosis of ICC patients was worse with increasing HTS grade. Additionally, multivariate regression analysis showed that HTS grade, carbohydrate antigen 19–9 (CA19-9), tumor differentiation, and vascular invasion were independent influencing factors for Overall survival (OS) and that HTS grade, CA19-9, CEA, vascular invasion and lymph node invasion were independent influencing factors for recurrence-free survival (RFS) (all P < 0.05). In the first, second, and third years of the training group, the AUCs for OS were 0.867, 0.902, and 0.881, and the AUCs for RFS were 0.849, 0.841, and 0.899, respectively. In the first, second, and third years of the validation group, the AUCs for OS were 0.727, 0.771, and 0.763, and the AUCs for RFS were 0.733, 0.746, and 0.801, respectively. Through the examination of calibration curves and using decision curve analysis (DCA), nomograms based on HTS grade showed excellent predictive performance. Conclusions Our nomograms based on HTS grade had excellent predictive effects and may thus be able to help clinicians provide individualized clinical decision for ICC patients.

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“…38 Beyond the TNM AJCC staging, several nomograms have been developed to better predict the outcomes -some of which have demonstrated better accuracy than the AJCC Cancer Staging manual. [39][40][41][42] The role of laparoscopy in staging has been controversial and debated. While some have advocated for staging laparoscopy due to a reported 27% to 38% incidence of detecting occult disease, others have cited the additional costs, extra time, and low yields associated with the procedure.…”

mentioning

confidence: 99%

Challenges and Opportunities for Treating Intrahepatic Cholangiocarcinoma

Serifis¹,

Tsilimigras²,

Cloonan³

et al. 2021

HMER

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A Nomogram in Predicting Risks of Intrahepatic Cholangiocarcinoma After Partial Hepatectomy for Hepatolithiasis

Cited by 6 publications

References 32 publications

Clinical online nomogram for predicting prognosis in recurrent hepatolithiasis after biliary surgery: A multicenter, retrospective study

Clinical online nomogram for predicting prognosis in recurrent hepatolithiasis after biliary surgery: A multicenter, retrospective study

Predictive value of HTS grade in patients with intrahepatic cholangiocarcinoma undergoing radical resection: a multicenter study from China

Challenges and Opportunities for Treating Intrahepatic Cholangiocarcinoma

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