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Performance of prognostic scores and staging systems in predicting long‐term survival outcomes after surgery for intrahepatic cholangiocarcinoma
Author(s) -
Buettner Stefan,
Galjart Boris,
van Vugt Jeroen L. A.,
Bagante Fabio,
Alexandrescu Sorin,
Marques Hugo P.,
Lamelas Jorge,
Aldrighetti Luca,
Gamblin T. Clark,
Maithel Shishir K.,
Pulitano Carlo,
Margonis Georgios A.,
Weiss Matthew,
Bauer Todd W.,
Shen Feng,
Poultsides George A.,
Marsh J. Wallis,
IJzermans Jan N. M.,
Groot Koerkamp Bas,
Pawlik Timothy M.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24759
Subject(s) - nomogram , medicine , concordance , ajcc staging system , cohort , retrospective cohort study , distributed file system , intrahepatic cholangiocarcinoma , staging system , tnm staging system , oncology , overall survival , surgery , cancer , computer security , computer science
We sought to validate the commonly used prognostic models and staging systems for intrahepatic cholangiocarcinoma (ICC) in a large multi‐center patient cohort. Methods The overall (OS) and disease free survival (DFS) prognostic discriminatory ability of various commonly used models were assessed in a large retrospective cohort. Harrell's concordance index (c‐index) was used to determine accuracy of model prediction. Results Among 1054 ICC patients, median OS was 37.7 months and 1‐, 3‐, and 5‐year survival, were 78.8%, 51.5%, and 39.3%, respectively. Recurrence of disease occurred in 454 (43.0%) patients with a median DFS of 29.6 months. One‐, 3‐ and 5‐ year DFS were 64.6%, 46.5 % and 44.4%, respectively. The prognostic models associated with the best OS prediction were the Wang nomogram (c‐index 0.668) and the Nathan staging system (c‐index 0.639). No model was proficient in predicting DFS. Only the Wang nomogram exceeded a c‐index of 0.6 for DFS (c‐index 0.602). The c‐index for the AJCC staging system was 0.637 for OS and 0.582 for DFS. Conclusions While the Wang nomogram had the best discriminatory ability relative to OS and DFS, no ICC staging system or nomogram demonstrated excellent prognostic discrimination. The AJCC staging for ICC performed reasonably, although its overall discrimination was only modest‐to‐good.