Predictive Value Of Constructing Nomogram For Postoperative Survival Of Patients With Intrahepatic Cholangiocarcinoma

Objective To analyze the survival factors of patients undergoing radical hepatectomy for intrahepatic cholangiocarcinoma and establish a nomogram to evaluate whether the nomogram can effectively predict individual survival time.Methods The clinicopathological data of 80 patients with intrahepatic cholangiocarcinoma who underwent radical hepatectomy were retrospectively analyzed.Cox regression model was used to screen independent risk factors affecting the survival of patients,and R language was used to establish the liver function after radical hepatectomy.Survival nomogram of patients with cholangiocarcinoma,using the consistency index C and calibration curve to validate the nomogram,and using the area under the ROC curve to compare the predictive effect of nomogram and TNM staging on postoperative patient survival.Results The median survival time for 80 patients was 16.0 months,with cumulative survival rates of 70.2%,41.5% and 26.3% at 1,2 and 3 years respectively.COX multivariate analysis results,CA19-9（HR=2.331,95%CI:1.117-4.865,P=0.024）,tumor number（HR=2.440,95%CI:1.168-5.098,P=0.018）,tumor differentiation degree（HR=2.129,95%CI: 1.060-4.273,P=0.034）,prognostic nutritional index（HR=0.551,95%CI: 0.314-0.989,P=0.046）were the independent risk factors affecting the survival time of patients with intrahepatic cholangiocarcinoma after surgery.Independent risk factors were constructed,and a nomogram was constructed.The consistency C-index was0.692,indicating that the nomogram had a good degree of discrimination.The calibration curve was close to the diagonal line,indicating that the predicted survival time of the line graph was more consistent with the actual survival time.The time-dependent area under the ROC curve of patients with cholangiocarcinoma after surgery for 1,2 and 3 years was0.783（95%CI: 0.672-0.895）,0.711（95%CI: 0.591-0.830）,0.726（95% CI: 0.602-0.853）,indicating that the predicted three-year survival rate is better.The AUC area under the ROC curve of the nomogram model for predicting postoperative survival was0.741（95%CI :0.579-0.903）,and the AUC area under the ROC curve of TNM staging was0.509（95%CI: 0.286-0.732）,which confirmed the prediction of the nomogram.The survival ability of postoperative patients was higher than that of TNM staging.Conclusion The nomogram constructed from CA19-9,tumor number,tumor differentiation,and prognostic nutritional index was more effective than TNM staging in predicting the survival time of postoperative patients with intrahepatic cholangiocarcinoma,and had the ability to estimate individual survival probability.