Predicting Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma.
The objective of the current study was to develop a model to predict the likelihood of occult lymph node metastasis (LNM) prior to resection of intrahepatic cholangiocarcinoma (ICC).Patients who underwent hepatectomy for ICC between 2000 and 2017 were identified using a multi-institutional database. A novel model incorporating clinical and preoperative imaging data was developed to predict LNM.Among 980 patients who underwent resection of ICC, 190 (19.4%) individuals had at least one LNM identified on final pathology. An enhanced imaging model incorporating clinical and imaging data was developed to predict LNM ( https://k-sahara.shinyapps.io/ICC_imaging/ ). The performance of the enhanced imaging model was very good in the training data set (c-index 0.702), as well as the validation data set with bootstrapping resamples (c-index 0.701) and outperformed the preoperative imaging alone (c-index 0.660). The novel model predicted both 5-year overall survival (OS) (low risk 48.4% vs. high risk 18.4%) and 5-year disease-specific survival (DSS) (low risk 51.9% vs. high risk 25.2%, both p < 0.001). When applied among Nx patients, 5-year OS and DSS of low-risk Nx patients was comparable with that of N0 patients, while high-risk Nx patients had similar outcomes to N1 patients (p > 0.05).This tool may represent an opportunity to stratify prognosis of Nx patients and can help inform clinical decision-making prior to resection of ICC.
Duke Scholars
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Related Subject Headings
- Surgery
- Prognosis
- Lymphatic Metastasis
- Lymph Nodes
- Humans
- Hepatectomy
- Cholangiocarcinoma
- Bile Ducts, Intrahepatic
- Bile Duct Neoplasms
- 3202 Clinical sciences
Citation
Published In
DOI
EISSN
ISSN
Publication Date
Volume
Issue
Start / End Page
Related Subject Headings
- Surgery
- Prognosis
- Lymphatic Metastasis
- Lymph Nodes
- Humans
- Hepatectomy
- Cholangiocarcinoma
- Bile Ducts, Intrahepatic
- Bile Duct Neoplasms
- 3202 Clinical sciences