Researchers from China developed a mutation-annotated prognostic score (MAPS) for intrahepatic cholangiocarcinoma (iCCA) after resection.

They said the model showed good performance in predicting overall survival and may also help predict the benefits of surgery and adjuvant therapy.

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The team first conducted a univariable Cox regression analysis in 3 screening cohorts of patients to assess the effect of individual mutant genes on overall survival.

Then, in a training set, they conducted a multivariable analysis to identify the independent prognostic roles of the mutational and clinicopathological parameters and constructed a prognostic model. 

Finally, they performed external and internal validations to test the performance of their model. 

They found that only mutations in the TP53 and KRASG12 genes among the recurrent mutations were associated with overall survival across all 3 screening cohorts. 

In the training cohort, mutations in the TP53 and KRASG12 genes, together with 7 other clinical parameters, were independent prognostic factors for overall survival. These parameters were the size and number of the tumors, adjacent invasion, vascular invasion, lymph node metastasis, carbohydrate antigen 19-9, and carcinoembryonic antigen CEA levels. 

The researchers established the MAPS based on these 9 prognosticators. They reported that the C-indices of their model were statistically higher than those of other existing models for internal and external validation cohorts at 0.782 and 0.731 respectively. 

“Furthermore, the MAPS model also demonstrated significant value in predicting the possible benefits of upfront surgery and adjuvant therapy,” the researchers said. 

CCA is a group of rare cancers originating in the bile ducts. It is responsible for about 15% of all primary liver tumors and is the second most common primary malignancy of the liver after hepatocellular carcinoma. 


Wang XY, Zhu WW, Lu L, et al. Development and validation of a mutation-annotated prognostic score (MAPS) for intrahepatic cholangiocarcinoma after resection: a retrospective cohort study. Int J Surg. Published online August 14, 2023. doi:10.1097/JS9.0000000000000636