Description

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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