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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
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated