Analysis Of Clinicopathological Factors Affecting The Prognosis Of Intrahepatic Cholangiocarcinoma After Radical Surgery

Objective: Intrahepatic cholangiocarcinoma is the second most common primary liver cancer,the incidence is lower than hepatocellular carcinoma,accounting for about 10% to 15% of primary liver cancer,and the incidence is increasing year by year,a serious threat to human health.Surgical resection is the first choice for the treatment of the disease,but there is no consistent conclusion on the factors affecting the surgical prognosis.It is of great significance to analyze the clinicopathological factors affecting the surgical prognosis of intrahepatic cholangiocarcinoma.Methods: A retrospective analysis was performed in 112 ICC patients who underwent radical resection surgery from December 2010 to April 2020 in the First Affiliated Hospital of China Medical University.A total of 33 prognostic factors which maybe affect prognosis were included in this study.Univariate analysis was used to screen out statistically significant factors by Kaplan-Meier method,and multivariate analysis was conducted by COX proportional hazard model,P<0.05 was considered statistically significant.According to the results of multivariate analysis,the nomogram model was made using the R language software,and the Bootstrap method was used to internally validate the model.Results: A total of 112 patients were included in the study.The median survival time was 27 months,the 1-year cumulative survival rate was 72.8%,the 3-year cumulative survival rate was 40.7%,and the 5-year cumulative survival rate was 34.0%.Univariate analysis results suggest that CEA,CA19-9,ALP,HBsAg,cholangiectasis,secondary or higher vascular invasion,local invasion,lymph node metastasis,number of tumors,degree of tumor differentiation,surgery resection range,and clinical TNM stage of tumors were related factors that influence the prognosis of ICC after radiacal surgery;multivariate analysis results suggest that HBsAg,vascular invasion,number of tumors,degree of tumor differentiation,and clinical TNM stage were independent risk factors for surgical prognosis of patients with ICC.Five independent risk factors were used to make nomogram model,and the internal verification was carried out.The results showed that the consistency index(C-index)was 0.782,indicating that the nomogram model had good accuracy;the calibration map of the model made was observed,and there was good consistency between the predicted survival rate of the nomogram model and the actual survival rate.Conclusions: According to the analysis of the clinical data of the included ICC patients,HBsAg,vascular invasion,number of tumors,tumor pathological differentiation and clinical TNM stage of tumors were independent risk factors affecting surgical prognosis.The nomogram model constructed by using the five factors of multivariate analysis had some reference value for judging the surgical prognosis of patients with ICC.