A new nomogram has been developed to help more precisely manage patients with intrahepatic cholangiocarcinoma (iCCA) postoperatively and postprogression, as published in Frontiers in Oncology. The nomogram is based on a study of progression patterns in these patients and has been verified in an external validation cohort.

“In the present study, we sought to compare the [postprogression survival] in iCCA patients with different progression patterns in multicenter patient cohorts and establish a prognostic nomogram to predict the [postprogression survival] of iCCA patients after radical surgical resection based on multicenter cohorts,” the authors wrote.

The research team assessed 396 consecutive patients diagnosed with iCCA undergoing surgical resection between January 2000 and December 2018 as the primary study cohort. A total of 107 similar patients from May 2013 and December 2019 comprised the validation cohort.


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Finally, a recurrence cohort was derived from 280 patients; 200 from the primary cohort, and 78 from the validation cohort. Imaging techniques were used to determine the progression patterns of all the patients, with biopsies in cases of ambiguous images.

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Based on the prognostic factors determined in the analysis of the patients’ progression, the research team constructed a nomogram to predict their 1- and 2-year postprogression survival rates. High agreement was found between actual and predicted survival of the primary and validation cohorts, and the nomogram outperformed the eighth tumor, node, and metastasis staging system for patients with recurrent iCCA.

Furthermore, the team found that postprogression survival was determined more by recurrence-related factors than my specific tumor characteristics, and liver metastasis accounted for most of the progression in these patients. Elevated carcinoembryonic antigen levels also contributed notably to postprogression survival. In contrast to related studies and the team’s expectations, the time to recurrence or progression was not significantly predictive of postprogression survival.

The authors recommend closer monitoring of patients classified as “high risk” by the nomogram, as well as early and regular adjuvant therapy for these patients.

Reference

Zhou C, He C, Lu J, et al. Progression patterns and post-progression survival in recurred intrahepatic cholangiocarcinoma patients: a novel prognostic nomogram based on multicenter cohorts. Front Oncol. Published online April 8, 2022. doi:10.3389/fonc.2022.832038