Endo et al evaluated a patient with intrahepatic cholangiocarcinoma who may be a candidate for adjuvant chemotherapy. The authors are from multiple institutions in the United States, Europe, Australia and Japan.
Patient selection: intrahepatic cholangiocarcinoma
Parameters:
(1) serum CA19-9 in U/mL
(2) tumor burden score (TBS)
(3) T category
(4) N category
(5) tumor grade
(6) morphological subtype
Parameter
Finding
Points
serum CA19-9
0.153 * LN(CA19-9)
tumor burden scale
0.089 * (TBS)
T category
T1
0
T2, T3, T4
0.549
N stage
N0
0
N1
1.355
Nx
0.566
tumor grade
well or moderately differentiated
0
poorly differentiated
0.633
morphological subtype
periductal infiltrating
0.785
periductal-infiltrating AND mass forming
0.785
other
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• The higher the score the worse the prognosis.
• The higher the risk the more likely adjuvant chemotherapy is considered.
Total Score
Risk Category
5-Year Overall Survival
< 1.5
low
69%
1.5 to 3.5
medium
34%
> 3.5
high
13%
Performance:
• The C-index is 0.74 in the derivation and 0.68 in the validation cohorts.
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