TY - JOUR
T1 - Predictive risk-score model to select patients with intrahepatic cholangiocarcinoma for adjuvant chemotherapy
AU - Endo, Yutaka
AU - Moazzam, Zorays
AU - Alaimo, Laura
AU - Lima, Henrique A.
AU - Munir, Muhammad M.
AU - Shaikh, Chanza F.
AU - Guglielmi, Alfredo
AU - Aldrighetti, Luca
AU - Weiss, Matthew
AU - Bauer, Todd W.
AU - Alexandrescu, Sorin
AU - Poultsides, George A.
AU - Kitago, Minoru
AU - Maithel, Shishir K.
AU - Marques, Hugo P.
AU - Martel, Guillaume
AU - Pulitano, Carlo
AU - Shen, Feng
AU - Cauchy, François
AU - Koerkamp, Bas G.
AU - Endo, Itaru
AU - Pawlik, Timothy M.
N1 - Publisher Copyright:
© 2022 International Hepato-Pancreato-Biliary Association Inc.
PY - 2023/2
Y1 - 2023/2
N2 - Background: The aim of this study was to develop a predictive model to identify individuals most likely to derive overall survival (OS) benefit from adjuvant chemotherapy (AC) after hepatic resection of intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent hepatic resection of ICC between 1990 and 2020 were identified from a multi-institutional database. Factors associated with worse OS were identified and incorporated into an online predictive model to identify patients most likely to benefit from AC. Results: Among 726 patients, 189 (26.0%) individuals received AC. Factors associated with OS on multivariable analysis included CA19-9 (Hazard Ratio [HR]1.17, 95%CI 1.04–1.31), tumor burden score (HR1.09, 95%CI 1.04–1.15), T-category (T2/3/4, HR1.73, 95%CI 1.73–2.64), nodal disease (N1, HR3.80, 95%CI 2.02–7.15), tumor grade (HR1.88, 95%CI 1.00–3.55), and morphological subtype (HR2.19, 95%CI 1.08–4.46). A weighted predictive score was devised and made available online (https://yutaka-endo.shinyapps.io/ICCrisk_model_for_AC/). Receipt of AC was associated with a survival benefit among patients at high/medium-risk (high: no AC, 0% vs. AC, 20.6%; medium: no AC, 36.4% vs. 40.8%; both p < 0.05) but not low-risk (low: no AC, 65.1% vs. AC, 65.1%; p = 0.73) tumors. Conclusion: An online predictive model based on tumor characteristics may help identify which patients may benefit the most from AC following resection of ICC.
AB - Background: The aim of this study was to develop a predictive model to identify individuals most likely to derive overall survival (OS) benefit from adjuvant chemotherapy (AC) after hepatic resection of intrahepatic cholangiocarcinoma (ICC). Methods: Patients who underwent hepatic resection of ICC between 1990 and 2020 were identified from a multi-institutional database. Factors associated with worse OS were identified and incorporated into an online predictive model to identify patients most likely to benefit from AC. Results: Among 726 patients, 189 (26.0%) individuals received AC. Factors associated with OS on multivariable analysis included CA19-9 (Hazard Ratio [HR]1.17, 95%CI 1.04–1.31), tumor burden score (HR1.09, 95%CI 1.04–1.15), T-category (T2/3/4, HR1.73, 95%CI 1.73–2.64), nodal disease (N1, HR3.80, 95%CI 2.02–7.15), tumor grade (HR1.88, 95%CI 1.00–3.55), and morphological subtype (HR2.19, 95%CI 1.08–4.46). A weighted predictive score was devised and made available online (https://yutaka-endo.shinyapps.io/ICCrisk_model_for_AC/). Receipt of AC was associated with a survival benefit among patients at high/medium-risk (high: no AC, 0% vs. AC, 20.6%; medium: no AC, 36.4% vs. 40.8%; both p < 0.05) but not low-risk (low: no AC, 65.1% vs. AC, 65.1%; p = 0.73) tumors. Conclusion: An online predictive model based on tumor characteristics may help identify which patients may benefit the most from AC following resection of ICC.
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U2 - 10.1016/j.hpb.2022.10.011
DO - 10.1016/j.hpb.2022.10.011
M3 - Article
C2 - 36396550
AN - SCOPUS:85142247797
SN - 1365-182X
VL - 25
SP - 229
EP - 238
JO - HPB
JF - HPB
IS - 2
ER -