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Dynamic Prediction of Survival After Curative Resection of Intrahepatic Cholangiocarcinoma: A Landmarking-Based Analysis.
- Source :
- Annals of Surgical Oncology: An Oncology Journal for Surgeons; Nov2022, Vol. 29 Issue 12, p7634-7641, 8p
- Publication Year :
- 2022
-
Abstract
- Background: The current study aimed to develop a dynamic prognostic model for patients undergoing curative-intent resection for intrahepatic cholangiocarcinoma (ICC) using landmark analysis. Methods: Patients who underwent curative-intent surgery for ICC from 1999 to 2017 were selected from a multi-institutional international database. A landmark analysis to undertake dynamic overall survival (OS) prediction was performed. A multivariate Cox proportional hazard model was applied to measure the interaction of selected variables with time. The performance of the model was internally cross-validated via bootstrap resampling procedure. Discrimination was evaluated using the Harrell's Concordance Index. Accuracy was evaluated with calibration plots. Results: Variables retained in the multivariable Cox regression OS model included age, tumor size, margin status, morphologic type, histologic grade, T and N category, and tumor recurrence. The effect of several variables on OS changed over time. Results were provided as a survival plot and the predicted probability of OS at the desired time in the future. For example, a 65-year-old patient with an intraductal, T1, grade 3 or 4 ICC measuring 3 cm who underwent an R0 resection had a calculated estimated 3-year OS of 76%. The OS estimate increased if the patient had already survived 1 year (79%). The discrimination ability of the final model was very good (C-index: 0.80). Conclusion: The long-term outcome for patients undergoing curative-intent surgery for ICC should be adjusted based on follow-up time and intervening events. The model in this study showed excellent discriminative ability and performed well in the validation process. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10689265
- Volume :
- 29
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Annals of Surgical Oncology: An Oncology Journal for Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 159576205
- Full Text :
- https://doi.org/10.1245/s10434-022-12156-1