Study on the value of the eighth edition of AJCC staging system in evaluating the prognosis of patients with intrahepatic cholangiocarcinoma after radical resection / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To explore the value of the 8 th edition of the AJCC staging system in evaluating the prognosis of patients with intrahepatic cholangiocarcinoma(ICC) after operation.METHODS: A total of 155 patients with ICC after radical resection in Eastern Hepatobiliary Surgery Hospital,Naval Military Medical University from January 2013 to December 2018 were analyzed retrospectively.All patients were staged according to the 8 th edition of the AJCC staging system.The survival rates were estimated using Kaplan-Meier methods.Multivariate analysis was assessed by Cox proportional hazards regression analysis.The predictive ability of staging systems was evaluated by receiver operating characteristic curve(ROC) and area under curve(AUC).RESULTS:(1) The follow-up rate of 155 patients was 70.3%,and the median follow-up time was 26(1-67) months.The 1-,3-,and 5-year survival rates of patients after surgery were81%,39%,and 25%,respectively.(2) The median survival time of T1 a,T1 b,T2,T3,and T4 stages was 45.5,28.8,19.1,18.9 and 16.2 months,respectively(P<0.001);The median survival time of N0 and N1 stages was 33.4 and 15.8 months,respectively(P<0.001);The median survival time of ⅠA,ⅠB,Ⅱ,Ⅲ A and Ⅲ B stages was 46.8,32.3,21.6,20.3 and 15.6 months,respectively(P<0.001).The ROC curve analysis of T stage,N stage and TNM stage indicated that the AUC were0.704,0.718 and 0.698,respectively.(3) Univariate analysis indicated that CA19-9,tumor number,vascular invasion,intraoperative blood transfusion,T stage,N stage and TNM stage were risk factors for prognosis in patients with ICC(P<0.05).Multivariate analysis indicated that the number of tumors,intraoperative blood transfusion,and N stage were independent risk factors for prognosis in patients with ICC(P<0.05).CONCLUSION: The 8 th edition of the AJCC staging system is of certain value in the evaluation of postoperative prognosis of intrahepatic cholangiocarcinoma.Multiple tumors,intraoperative blood transfusion and N stage are independent prognostic factors for ICC patients.