Establishment and validation of a prognostic nomogram for patients with resectable perihilar cholangiocarcinoma.
Establishment and validation of a prognostic nomogram for patients with resectable perihilar cholangiocarcinoma.
复制标题
可切除肝门周围胆管癌患者预后列线图的建立和验证
DOI：
10.18632/oncotarget.9104
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发表时间：
2016-06-14
期刊：
影响因子：
--
通讯作者：
Jiang X
中科院分区：
文献类型：
--
作者：
Chen P;Li B;Zhu Y;Chen W;Liu X;Li M;Duan X;Yi B;Wang J;Liu C;Luo X;Li X;Li J;Liang L;Yin X;Wang H;Jiang X
针对传统分期系统对肝门周围胆管癌（perihilar cholangiocarcinoma，pCCA）患者预后预测能力差的问题，结合pCCA患者的个体特征和肿瘤特征，建立并验证了一种有效的pCCA患者预后诺模图。从2000年到2009年，共招募了235名在东部肝胆外科医院接受根治性切除术的患者作为主要培训队列。多变量分析表明，年龄、术前CA 19 -9水平、门静脉受累、肝动脉浸润、淋巴结转移和手术治疗结局（R 0或R1/2）是主要队列中pCCA患者的独立预后因素，这些因素均纳入已建立的列线图中。校准曲线显示，列线图预测的pCCA患者的总生存概率与实际观察结果之间具有良好的一致性，一致性指数（C指数）为0.68（95%CI，0.61-0.71）。C指数值和时间依赖性ROC检验表明，诺模图上级传统的分期系统，包括Bismuth-Corlette，Gazzaniga，纪念斯隆凯特琳癌症中心（MSKCC），美国癌症联合委员会（AJCC）TNM第7版，马约诊所。诺模图在预测PCCA患者的总生存率方面也优于传统分期系统，内部队列包括来自同一机构的93例PCCA患者，外部验证队列包括来自另一机构的84例PCCA患者，如C指数值和时间依赖性ROC检验所示。总之，提出的诺模图对可切除的pCCA患者的预后具有上级预测准确性。
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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影响因子：
29.4
作者：
Ilyas SI;Gores GJ
通讯作者：
Gores GJ
DOI：
10.1158/1078-0432.ccr-14-0365
发表时间：
2015-02-01
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
O'Brien DP;Sandanayake NS;Jenkinson C;Gentry-Maharaj A;Apostolidou S;Fourkala EO;Camuzeaux S;Blyuss O;Gunu R;Dawnay A;Zaikin A;Smith RC;Jacobs IJ;Menon U;Costello E;Pereira SP;Timms JF
通讯作者：
Timms JF
影响因子：
3.5
作者：
Williams, Terence M.;Majithia, Lonika;Thomas, Charles R., Jr.
通讯作者：
Thomas, Charles R., Jr.
影响因子：
9
作者：
Jarnagin, WR;Fong, Y;Blumgart, LH
通讯作者：
Blumgart, LH
影响因子：
--
作者：
Wang, Ren-Jie;Song, Bao-Rong;Xu, Ye
通讯作者：
Xu, Ye