A novel preoperative inflammation score system established for postoperative prognosis predicting of intrahepatic cholangiocarcinoma

Jun Fu; Qinjunjie Chen; Zisen Lai; Kongying Lin; Guoxu Fang; Zongren Ding; Yuzhen Gao; Yongyi Zeng

doi:10.1186/s12885-023-10668-x

A novel preoperative inflammation score system established for postoperative prognosis predicting of intrahepatic cholangiocarcinoma

BMC Cancer. 2023 Feb 24;23(1):188. doi: 10.1186/s12885-023-10668-x.

Authors

Jun Fu^#¹, Qinjunjie Chen^#², Zisen Lai^#¹, Kongying Lin¹, Guoxu Fang¹, Zongren Ding¹, Yuzhen Gao³, Yongyi Zeng⁴

Affiliations

¹ Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, 312 Xihong Road, Fuzhou, China.
² Department of Hepatic Surgery IV, the Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
³ Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁴ Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, 312 Xihong Road, Fuzhou, China. lamp197311@126.com.

^# Contributed equally.

Abstract

Background: Inflammation is implicated in tumorigenesis and has been reported as an important prognostic factor in cancers. In this study, we aimed to develop and validate a novel inflammation score (IFS) system based on 12 inflammatory markers and explore its impact on intrahepatic cholangiocarcinoma (ICC) survival after hepatectomy.

Methods: Clinical data of 446 ICC patients undergoing surgical treatment were collected from the Primary Liver Cancer Big Data, and then served as a training cohort to establish the IFS. Furthermore, an internal validation cohort including 175 patients was used as internal validation cohort of the IFS. A survival tree analysis was used to divide ICC patients into three groups (low-, median-, and high- IFS-score groups) according to different IFS values. Kaplan-Meier (KM) curves were used to compare the overall survival (OS) and recurrence-free survival (RFS) rates among three different groups. Cox regression analyses were applied to explore the independent risk factors influencing OS and RFS.

Results: In the training cohort, 149 patients were in the low-IFS-score group, 187 in the median-IFS-score group, and 110 in the high-IFS-score group. KM curves showed that the high-IFS-score group had worse OS and RFS rates than those of the low- and median-IFS-score groups (P < 0.001) in both the training and validation cohorts. Moreover, multivariable Cox analyses identified high IFS as an independent risk factor for OS and RFS in the training cohort. The area under the curve values for OS prediction of IFS were 0.703 and 0.664 in the training and validation cohorts, respectively, which were higher than those of the American Joint Committee on Cancer (AJCC) 7th edition TNM stage, AJCC 8th edition TNM stage, and the Child-Pugh score.

Conclusion: Our results revealed the IFS was an independent risk factor for OS and RFS in patients with ICC after hepatectomy and could serve as an effective prognostic prediction system in daily clinical practice.

Keywords: Intrahepatic cholangiocarcinoma; Liver resection; Prognosis; Systemic inflammation.

MeSH terms

Bile Duct Neoplasms* / pathology
Bile Ducts, Intrahepatic / pathology
Cholangiocarcinoma* / pathology
Hepatectomy
Humans
Inflammation / surgery
Prognosis