Factors affecting of postoperative survival outcomes and construction of a predictive model for patients with intrahepatic cholangiocarcinoma

WANG Tao; XIE Weixuan

doi:10.3969/j.issn.1674-4136.2025.02.013

Abstract：Objective To explore the factors affecting of the postoperative survival outcome of patients with intrahepatic cholangiocarcinoma(ICC),and to establish a nomographic model to verify the predictive value.Methods A retrospective analysis was performed on 110 ICC patients treated in the 904th Hospital of the PLA Joint Logistic Support Force from January 2018 to August 2021,all of whom underwent hepatectomy.The patients were followed up for 3 years after surgery.General data,tumor markers,TNM stage,tumor size,lymph node metastasis and other clinical data were collected.Multivariate Cox regression analysis was used to determine the main factors affecting postoperative prognosis of patients with intrahepatic cholangiocarcinoma(ICC),and a survival prediction nomogram model was constructed.The ROC curve and calibration curve were used to evaluate the discrimination and calibration degree of the model.Results The first,second and third year cumulative relapse-free survival rates were 43.01%,26.56%and 20.33%,respectively,and the median survival time was 14 months.The cumulative overall survival rates of 110 patients at the first,second and third years after surgery were 62.34%,41.78%and 27.63%,respectively.Multivariate analysis showed that age≥65 years old,high T stage,presence of lymph node metastasis,distant metastasis,and tumor diameter≥5 cm were all independent risk factors affecting survival rate and disease recurrence.The consistency index was 0.723(95%CI:0.662-0.790),and the AUC for the first,second and third year survival rates were 0.781(95%CI:0.678-0.871),0.841(95%CI:0.767-0.913),and 0.766(95%CI:0.671-0.862),respectively.Conclusions When developing individualized surgical plans for intrahepatic cholangiocarcinoma(ICC),it is essential to holistically evaluate tumor characteristics including multiplicity,dimensions,presence of vascular invasion,and involvement of adjacent organs.This comprehensive assessment forms the basis for selecting appropriate hepatectomy strategies,which is pivotal for optimizing patient prognosis and extending overall survival.The decision-making process should incorporate precise evaluation of tumor biology and anatomical relationships to ensure complete oncological resection while preserving adequate liver function.