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Prognostic value and predication model of microvascular invasion in patients with intrahepatic cholangiocarcinoma: a multicenter study from China

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单位: [1]Fujian Med Univ, Dept Hepatopancreatobiliary Surg, Mengchao Hepatobiliary Hosp, Xihong Rd 312, Fuzhou 350025, Fujian, Peoples R China [2]Secondary Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg 3, Shanghai, Peoples R China [3]Southeast Univ, Dept Hepatobiliary Surg, Affiliated Zhongda Hosp, Nanjing, Peoples R China [4]Zhejiang Univ, Dept Hepatobiliary Surg, Hosp Affiliated 2, Hangzhou, Peoples R China [5]Army Med Univ, Dept Hepatobiliary Surg, Southwest Hosp, Chongqing, Peoples R China [6]Chinese Acad Med Sci, Canc Hosp, Dept Hepatobiliary Surg, Beijing, Peoples R China [7]Huazhong Univ Sci & Technol,Tongji Med Coll,Dept Hepatobiliary Surg,Tongji Hosp,Wuhan,Peoples R China [8]Capital Med Univ, Dept Hepatobiliary Surg, Beijing Friendship Hosp, Beijing, Peoples R China [9]Sichuan Univ, Dept Hepatobiliary Surg, West China Hosp, Chengdu, Peoples R China [10]Shanghai Jiao Tong Univ, Dept Hepatobiliary Surg, Renji Hosp, Shanghai, Peoples R China [11]Capital Med Univ, Dept Hepatobiliary Surg, Xuanwu Hosp, Beijing, Peoples R China [12]Chuanbei Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp, Nanchong, Peoples R China [13]Capital Med Univ, Dept Hepatobiliary Surg, Tiantan Hosp, Beijing, Peoples R China [14]Fujian Med Univ, Affiliated Hosp 1, Liver Dis Ctr, Fuzhou, Peoples R China
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关键词: Intrahepatic cholangiocarcinoma Microvascular invasion Prognosis Prediction model

摘要:
Background At present, hepatectomy is still the most common and effective treatment method for intrahepatic cholangiocarcinoma (ICC) patients. However, the postoperative prognosis is poor. Therefore, the prognostic factors for these patients require further exploration. Whether microvascular invasion (MVI) plays a crucial role in the prognosis of ICC patients is still unclear. Moreover, few studies have focused on preoperative predictions of MVI in ICC patients. Methods Clinicopathological data of 704 ICC patients after curative resection were retrospectively collected from 13 hospitals. Independent risk factors were identified by the Cox or logistic proportional hazards model. In addition, the survival curves of the MVI-positive and MVI-negative groups before and after matching were analyzed. Subsequently, 341 patients from a single center (Eastern Hepatobiliary Hospital) in the above multicenter retrospective cohort were used to construct a nomogram prediction model. Then, the model was evaluated by the index of concordance (C-Index) and the calibration curve. Results After propensity score matching (PSM), Child-Pugh grade and MVI were independent risk factors for overall survival (OS) in ICC patients after curative resection. Major hepatectomy and MVI were independent risk factors for recurrence-free survival (RFS). The survival curves of OS and RFS before and after PSM in the MVI-positive groups were significantly different compared with those in the MVI-negative groups. Multivariate logistic regression results demonstrated that age, gamma-glutamyl transpeptidase (GGT), and preoperative image tumor number were independent risk factors for the occurrence of MVI. Furthermore, the prediction model in the form of a nomogram was constructed, which showed good prediction ability for both the training (C-index = 0.7622) and validation (C-index = 0.7591) groups, and the calibration curve showed good consistency with reality. Conclusion MVI is an independent risk factor for the prognosis of ICC patients after curative resection. Age, GGT, and preoperative image tumor number were independent risk factors for the occurrence of MVI in ICC patients. The prediction model constructed further showed good predictive ability in both the training and validation groups with good consistency with reality.

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
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出版当年[2019]版:
Q3 ONCOLOGY
最新[2023]版:
Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者单位: [1]Fujian Med Univ, Dept Hepatopancreatobiliary Surg, Mengchao Hepatobiliary Hosp, Xihong Rd 312, Fuzhou 350025, Fujian, Peoples R China
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通讯机构: [1]Fujian Med Univ, Dept Hepatopancreatobiliary Surg, Mengchao Hepatobiliary Hosp, Xihong Rd 312, Fuzhou 350025, Fujian, Peoples R China [14]Fujian Med Univ, Affiliated Hosp 1, Liver Dis Ctr, Fuzhou, Peoples R China
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