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Patients with intrahepatic cholangiocarcinoma (ICC) undergoing partial hepatectomy may benefit from a new noninvasive method that successfully predicts overall survival (OS) after surgery.

In an effort to identify patients with ICC and high risk of death, Yang and colleagues conducted a retrospective study that developed an OS stratification method using radiomic models that analyzed multiple magnetic resonance imaging (MRI) parameters. 

The study published in the Journal of Magnetic Resonance Imaging included 163 patients with a median OS of 24.9 months. Out of the 4998 radiomic features studied, 7 mainly were linked to survival outcomes. In the validation phase of the study, patients classified with a high risk of death according to the proposed radiomic signature had a 3-year OS of 17.1%, vs low-risk patients that resulted in 56.4% OS.


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Although the tumor, node, and metastasis (TNM) classification, along with other survival prediction models, are accepted and vastly used for ICC, its implementation usually requires an invasive or postoperative study of the tumor, in contrast with the radiomic technology that allows a comprehensive characterization of the tumor including gross morphologic features as well as histopathologic characteristics.

In the context of ICC, where post-surgical OS remains suboptimal, the authors noted that “preoperative prognostic markers or models may be more useful for identifying patients with poor outcomes before surgery and for recommending an alternative treatment strategy, such as preoperative neoadjuvant chemotherapy and postoperative adjuvant transarterial chemoembolization.”

Moreover, when comparing the prognostic value of this MRI-based radiomic signature for each TNM stage, the study found that TNM III-VI-classified patients had a significantly higher death risk in the 3 years after surgery compared with TNM I-II-classified patients. Interestingly, the OS did not vary significantly between TNM I and II or between TNM III and IV.

Lastly, although yielding promising results, the authors acknowledged the study’s limitations given the small sample size due to the rarity of ICC; therefore, they wrote that further multicenter prospective studies must be conducted to acquire external validation. 

Reference

Yang Y, Zou X, Zhou W, et al. Multiparametric MRI-based radiomic signature for preoperative evaluation of overall survival in intrahepatic cholangiocarcinoma after partial hepatectomy. J Magn Reson Imaging. Published online January 20, 2022. doi:10.1002/jmri.28071