Prognostic influence for hilar cholangiocarcinoma and comparisons of prognostic values of Mayo staging and TNM staging systems

Abstract

The study was designed to discuss the effect of stratification factors in the Mayo staging on the prognosis of hilar cholangiocarcinoma (HCCA) patients, and to evaluate the predictive value of the Mayo staging on the prognosis. The Kaplan–Meier survival curve and Log-rank test were used to perform univariate analysis on each index and obtain statistically significant influencing factors. The Kaplan–Meier survival curve and Log-rank test were used to analyze the correlation between the two staging systems and the survival period. The receiver operating characteristic (ROC) curves were used for each single staging system trend analysis, and comparison of their curve area to determine prognosis prediction ability for patients with HCCA. According to Kaplan–Meier survival curve changes and Log-rank test results, it was found that both staging systems were correlated with the survival time of the patients ( P < .001). Through a pairwise comparison within the stages, it was found that the heterogeneity between the stages within the Mayo staging is very good, which was better than the TNM staging. A single trend analysis of the prognostic assessment capabilities of the two systems found that the area under the ROC curve of Mayo staging system (AUC = 0.587) was the largest and better than the TNM staging system (AUC = 0.501). Mayo staging can be used for preoperative patient prognosis assessment which can provide better stratification ability based on a single-center small sample study, and the predictive value is better than TNM staging.

CT texture analysis of perihilar cholangiocarcinoma – associations with tumor grading, tumor markers and clinical outcome

“…Also, lymph node involvement is an important factor as a further independent predictor of the outcome (22). At the current time, the widely used TNM-staging system and also the Mayo-staging system are enabling preoperative patient prognosis assessment, although the analysis of their prognostic capabilities just have been reported of wielding areas under the curve of only 0.50 and 0.59, respectively (23). Therefore, there is de nte need for better characterization of these patients and to provide novel prognostic biomarkets.…”

“…Another work group performed a radiomics study on presurgical MRI and found that a combined clinical and radiomics based nomogram performed signi cantly better in the prediction of 1-, 3-and 5-year survival than the classical TNM-staging system [23]. When comparing the different nomograms, the combined clinical and radiomic approach performed only slightly better than the radiomic nomogram, although with no statistical signi cant difference.…”