TY - JOUR
T1 - Lymph Node Ratio Nomogram-Based Prognostic Model for Resected Distal Cholangiocarcinoma
AU - Perez, Marc
AU - Hansen, Carsten Palnaes
AU - Burdio, Fernando
AU - Pellino, Gianluca
AU - Pisanu, Adolfo
AU - Salvia, Roberto
AU - Di Martino, Marcello
AU - Hilal, Mohammad Abu
AU - Aldrighetti, Luca
AU - Ielpo, Benedetto
N1 - Publisher Copyright:
© 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - BACKGROUND: Several variables have been described as prognostic factors for resected distal cholangiocarcinoma (dCC), including lymph node metastases (N status) and lymph node ratio (LNR). The present study aimed to evaluate the prognostic value of LNR on survival and to establish a novel prognostic nomogram to predict the cancer-specific recurrence-free survival (RFS) of dCC. STUDY DESIGN: Between December 2006 and September 2020, 415 consecutive patients who underwent pancreaticoduodenectomy (PD) for dCC in 10 centers were identified. Multivariate Cox analysis was used to identify all independent risk factors among several prognostic factors. A nomogram was then developed and assessed by integrating the independent prognostic factors into the model, and the concordance index (C-index) was used to evaluate its performance. RESULTS: According to Cox regression multivariate analysis, a nomogram based on independent prognostic factor for RFS was performed including LNR 15 (hazard ratio [HR] 2.442, 95% CI 1.348–4.425, p = 0.003), perineural invasion (HR 3.100, 95% CI 1.183–8.122, p = 0.025), differentiation grade (HR 2.100, 95% CI 1.172–4.143, p = 0.021), and radicality of PD (HR 2.276, 95% CI 1.223–4.234, p = 0.009). The C-index of the nomogram, tailored based on the previous significant factors, was 0.8. CONCLUSIONS: LNR15 yields a high prognostic efficiency for RFS. The nomogram based on LNR can provide an accurate prognosis assessment for patients with resected dCC.
AB - BACKGROUND: Several variables have been described as prognostic factors for resected distal cholangiocarcinoma (dCC), including lymph node metastases (N status) and lymph node ratio (LNR). The present study aimed to evaluate the prognostic value of LNR on survival and to establish a novel prognostic nomogram to predict the cancer-specific recurrence-free survival (RFS) of dCC. STUDY DESIGN: Between December 2006 and September 2020, 415 consecutive patients who underwent pancreaticoduodenectomy (PD) for dCC in 10 centers were identified. Multivariate Cox analysis was used to identify all independent risk factors among several prognostic factors. A nomogram was then developed and assessed by integrating the independent prognostic factors into the model, and the concordance index (C-index) was used to evaluate its performance. RESULTS: According to Cox regression multivariate analysis, a nomogram based on independent prognostic factor for RFS was performed including LNR 15 (hazard ratio [HR] 2.442, 95% CI 1.348–4.425, p = 0.003), perineural invasion (HR 3.100, 95% CI 1.183–8.122, p = 0.025), differentiation grade (HR 2.100, 95% CI 1.172–4.143, p = 0.021), and radicality of PD (HR 2.276, 95% CI 1.223–4.234, p = 0.009). The C-index of the nomogram, tailored based on the previous significant factors, was 0.8. CONCLUSIONS: LNR15 yields a high prognostic efficiency for RFS. The nomogram based on LNR can provide an accurate prognosis assessment for patients with resected dCC.
UR - http://www.scopus.com/inward/record.url?scp=85140274804&partnerID=8YFLogxK
U2 - 10.1097/XCS.0000000000000299
DO - 10.1097/XCS.0000000000000299
M3 - Article
C2 - 36102558
AN - SCOPUS:85140274804
VL - 235
SP - 703
EP - 712
IS - 5
ER -
