The preoperative prognostic value of the radiomics nomogram based on CT combined with machine learning in patients with intrahepatic cholangiocarcinoma

Abstract

Background Intrahepatic cholangiocarcinoma is an aggressive liver carcinoma with increasing incidence and mortality. A good auxiliary prognostic prediction tool is desperately needed for the development of treatment strategies. The purpose of this study was to explore the prognostic value of the radiomics nomogram based on enhanced CT in intrahepatic cholangiocarcinoma. Methods In this retrospective study, 101 patients with pathological confirmation of intrahepatic cholangiocarcinoma were recruited. A radiomics nomogram was developed by radiomics score and independent clinical risk factors selecting from multivariate Cox regression. All patients were stratified as high risk and low risk by a nomogram. Model performance and clinical usefulness were assessed by calibration curve, ROC curve, and survival curve. Results A total of 101patients (mean age, 58.2 years old; range 36–79 years old) were included in the study. The 1-year, 3-year, and 5-year overall survival rates were 49.5%, 26.6%, and 14.4%, respectively, with a median survival time of 12.2 months in the whole set. The least absolute shrinkage and selection operator (LASSO) method selected 3 features. Multivariate Cox analysis found three independent prognostic factors. The radiomics nomogram showed a significant prognosis value with overall survival. There was a significant difference in the 1-year and 3-year survival rates of stratified high-risk and low-risk patients in the whole set (30.4% vs. 56.4% and 13.0% vs. 30.6%, respectively, p = 0.018). Conclusions This radiomics nomogram has potential application value in the preoperative prognostic prediction of intrahepatic cholangiocarcinoma and may facilitate in clinical decision-making.

Development and validation of nomogram to predict very early recurrence of combined hepatocellular-cholangiocarcinoma after hepatic resection: a multi-institutional study

“…Previous studies elucidated that the elevation of CA19-9 reflects extensive tumor burden, which signifies biologically aggressive behavior, poor differentiation and greater tumor volume of ICC, and correlates with bleak prognosis in ICC [ 29 , 37 , 38 ]. Consistent with this conclusion, some researchers declared the elevation of CA19-9 to be an independent risk factor for RFS and OS in cHCC [ 5 , 29 ].…”

“…Consistent with this conclusion, some researchers declared the elevation of CA19-9 to be an independent risk factor for RFS and OS in cHCC [ 5 , 29 ]. It is well known that CA19-9 is a biomarker for ICC components and the prognosis of ICC is worse than that of HCC [ 2 , 37 , 38 ]. Ideally, more portion of ICC lead to worse prognosis for cHCC patients, i.e., ICC dominance (defined as ICC components more than 50% or 80% pathologically according to different studies) is an independent risk factor for recurrence and survival in cHCC.…”

A Novel Clinical-Radiomics Model Based on Sarcopenia and Radiomics for Predicting the Prognosis of Intrahepatic Cholangiocarcinoma After Radical Hepatectomy

“…Radiomics was first proposed by Lambin (9). It is a technique to quantify tumor heterogeneity by high-throughput extraction of quantitative imaging features such as texture and morphology of lesions from computed tomography (CT), magnetic resonance imaging, and positron emission tomography images, and has become a method to evaluate tumor phenotypes and guide clinical decision-making (10)(11)(12). It has been used in the diagnosis, biological behavior prediction, and post-treatment evaluation of ICC (13)(14)(15)(16)(17).…”

The Role of m6A Epigenetic Modification in the Treatment of Colorectal Cancer Immune Checkpoint Inhibitors

“…Given that the body’s immune system plays a vital role in the development and progression of tumors, tumor immunotherapy utilizing the body’s own immune system to fight against tumor cells is booming. Immunotherapy is expected to become a new development following surgery, chemotherapy, radiotherapy, and targeted tumor therapy as a generation of tumor treatment methods ( 5 , 6 ). The goal of tumor immunotherapy is to release the negative regulatory mechanism in the body and then enhance the immune response of cancer immunity ( 27 ).…”

“…The current management strategies for colorectal cancer mainly include surgery, chemotherapy, radiotherapy, and immunotherapy ( 5 , 6 ). Among them, cancer immunotherapy, containing active immunotherapy, passive immunotherapy, and immune checkpoint inhibitors, is gradually becoming the mainstream of modern cancer treatment ( 7 ), which has become a new research direction for cancer treatment and has received extensive attention ( 8 , 9 ).…”