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Model to predict survival after surgical resection of intrahepatic cholangiocarcinoma: the Mayo Clinic experience.
[cholangiocarcinoma]
The
7
th
edition
of
the
American
Joint
Committee
on
Cancer
(
AJCC
)
staging
system
has
recently
been
validated
and
shown
to
predict
survival
in
patients
with
intrahepatic
cholangiocarcinoma
(
ICC
)
.
The
present
study
attempted
to
investigate
the
validity
of
these
findings
.
A
single
-centre
,
retrospective
cohort
study
was
conducted
.
Histopathological
restaging
of
disease
subsequent
to
primary
surgical
resection
was
carried
out
in
all
consecutive
ICC
patients
.
Overall
survival
was
compared
using
Kaplan-
Meier
estimates
and
log-rank
tests
.
A
total
of
150
patients
underwent
surgery
,
126
(
84
%
)
of
whom
met
the
present
study
's
inclusion
criteria
.
Of
these
126
patients
,
68
(
54
%
)
were
female
.
The
median
length
of
follow-up
was
4
.
5
years
.
The
median
patient
age
was
58
years
(
range
:
24
-
79
years
)
.
Median
body
mass
index
was
27
kg
/
m
(
2
)
(
range
:
17
-
46
kg
/
m
(
2
)
)
.
Staging
according
to
the
AJCC
7
th
edition
categorized
33
(
26
%
)
patients
with
stage
I
disease
,
27
(
21
%
)
with
stage
II
disease
,
five
(
4
%
)
with
stage
III
disease
,
and
61
(
48
%
)
with
stage
IVa
disease
.
The
AJCC
7
th
edition
failed
to
accurately
stratify
survival
in
the
current
cohort
;
analysis
revealed
significantly
worse
survival
in
those
with
microvascular
invasion
,
tumour
size
of
>
5
cm
,
grade
4
disease
,
multiple
tumours
and
positive
lymph
nodes
(
P
<
0
.
001
)
.
A
negative
resection
margin
was
associated
with
improved
survival
(
P
<
0
.
001
)
.
The
AJCC
7
th
edition
did
not
accurately
predict
survival
in
patients
with
ICC
.
A
multivariable
model
including
tumour
size
and
differentiation
in
addition
to
the
criteria
used
in
the
AJCC
7
th
edition
may
offer
a
more
accurate
method
of
predicting
survival
in
patients
with
ICC
.
