A model for predicting post-liver transplantation recurrence in intrahepatic cholangiocarcinoma recipients.
A model for predicting post-liver transplantation recurrence in intrahepatic cholangiocarcinoma recipients.
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DOI：
10.21037/jgo-20-209
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发表时间：
2020-12
影响因子：
2.1
通讯作者：
Ao Ren;Zhongqiu Li;Xuzhi Zhang;R. Deng;Yi Ma
中科院分区：
文献类型：
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作者：
Ao Ren;Zhongqiu Li;Xuzhi Zhang;R. Deng;Yi Ma
背景 选择合适的患者对于改善肝内胆管癌（iCCA）肝移植的结局非常重要。本研究的目的是建立肝移植后 iCCA 复发的预测模型。方法采用21例因iCCA而接受肝移植的患者构建复发预测模型。通过 Cox 模型分析测试复发的预测因子。结果在 28 名接受随访的患者中得到验证。结果肿瘤直径和数量以及CA19-9水平独立预测肿瘤复发。在 Cox 评分阈值为 0.736 [95% 置信区间 (CI)：0.549-0.923] 时，结合这些因素的模型可以高度预测肿瘤复发和死亡。该模型的简化版本确定了临界值为 6。与评分 ≤ 6 分的患者相比，评分 > 6 分的患者的 5 年 OS 率较低 (P = 0.005)。评分>6分的患者5年复发率高于评分≤6分的患者（P=0.034）。结论 所建立的模型可用于预测肝移植术后 iCCA 的复发。需要大样本、多中心研究来验证研究结果。
Background It is important to select appropriate patients for improving the outcomes of liver transplantation for intrahepatic cholangiocarcinoma (iCCA). The objective of this study was to establish a predictive model for the recurrence of iCCA after liver transplantation. Methods Twenty-one patients who received liver transplantation for iCCA were used to construct a model for predicting recurrence. Predictors of recurrence were tested by a Cox model analysis. The results were validated in 28 patients who were followed up. Results Diameter and number of tumors, and CA19-9 level independently predicted tumor recurrence. At a Cox score threshold of 0.736 [95% confidence interval (CI): 0.549-0.923], a model combining these factors was highly predictive of tumor recurrence and death. A simplified version of the model identified a cut-off value of 6. The 5-year OS rate was lower in patients with a score >6 points compared to those with a score ≤6 points (P=0.005). The 5-year recurrence rate was higher in patients with a score >6 points as compared to those with a score ≤6 points (P=0.034). Conclusions The model developed was useful for predicting recurrence of iCCA after liver transplantation. Large sample, multicenter studies are needed to validate the findings.