Faculty Collaboration Database

A Comparison of Prognostic Schemes for Perihilar Cholangiocarcinoma. J Gastrointest Surg 2016 Oct;20(10):1716-24

Date

07/15/2016

Pubmed ID

27412318

Pubmed Central ID

PMC5450027

DOI

10.1007/s11605-016-3203-2

Scopus ID

2-s2.0-84978127396 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

INTRODUCTION: Although widely used, the 7th edition American Joint Committee on Cancer (AJCC) staging system for perihilar cholangiocarcinoma (PHC) may be limited. Disease-specific nomograms have been proposed as a better means to predict long-term survival for individual patients. We sought to externally validate a recently proposed nomogram by Memorial Sloan Kettering Cancer Center (MSKCC) for PHC, as well as identify factors to improve the prediction of prognosis for patients with PHC.

METHODS: Four hundred seven patients who underwent surgery for PHC between 1988 and 2014 were identified using an international, multi-center database. Standard clinicopathologic and outcome data were collected. The predictive power of the AJCC staging system and nomogram were assessed.

RESULTS: Median survival was 24.4 months; 3- and 5-year survival was 37.2 and 20.8 %, respectively. The AJCC 7th edition staging system (C-index 0.570) and the recently proposed PHC nomogram (C-index 0.587) both performed poorly. A revised nomogram based on age, lymphovascular invasion, perineural invasion, and lymph node metastases performed better (C-index 0.682). The calibration plot of the revised PHC nomogram demonstrated good calibration.

CONCLUSION: The 7th edition AJCC staging system and the MSKCC nomogram had a poor ability to predict long-term survival for individual patients with PHC. A revised nomogram provided more accurate prediction of survival, but will need to be externally validated.

Author List

Buettner S, van Vugt JL, Gani F, Groot Koerkamp B, Margonis GA, Ethun CG, Poultsides G, Tran T, Idrees K, Isom CA, Fields RC, Krasnick B, Weber SM, Salem A, Martin RC, Scoggins C, Shen P, Mogal HD, Schmidt C, Beal E, Hatzaras I, Shenoy R, Maithel SK, Guglielmi A, IJzermans JN, Pawlik TM

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms
Databases, Factual
Female
Humans
Klatskin Tumor
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Nomograms
Prognosis
Reproducibility of Results