A New Prognostic Model Covering All Stages of Intrahepatic Cholangiocarcinoma

Shuang Nan Zhou, Shan Shan Lu, Da Wei Ju, Ling Xiang Yu, Xiao Xiao Liang, Xiao Xiang, Suthat Liangpunsakul, Lewis R. Roberts, Yin Ying Lu, Ning Zhang

Research output: Contribution to journalArticlepeer-review


Background and Aims: Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy that causes a poor survival. We aimed to identify its prognostic factors and to develop a nomogram that will predict survival of ICC patients among all stages. Methods: A total of 442 patients with pathology-proven ICC registered at the Fifth Medical Center of PLA General Hospital between July 2007 and December 2019 were enrolled. Subjects were followed for survival status until June 30, 2020. A prognostic model visualized as a nomogram was constructed in the training cohort using multivariate cox model, and was then validated in the validation cohort. Results: The median age was 55 years. With a median follow-up of 50.4 months, 337 patients died. The median survival was 11.6 months, with 1-, 3-and 5-year survival rates of 48.3%, 22.7% and 16.2%, respectively. Factors associated with overall survival were multiple tumors, lymph node involvement, vascular invasion, distant metastasis, decreased albumin, elevated lactate dehydrogenase (LDH), decreased iron, elevated fibrinogen, elevated CA125 and elevated CA19-9. A nomogram predicting survival of ICC patients at the time of diagnosis achieved a Harrel’s c-statistic of 0.758, significantly higher than the 0.582 of the TNM stage alone. Predicted median survivals of those within the low, mid and high-risk subgroups were 35.6, 12.1 and 6.2 months, respectively. Conclusions: A nomogram based on imaging data and serum biomarkers at diagnosis showed good ability to predict survival in patients with all stages of ICC. Further studies are needed to validate the prognostic capability of our new model.

Original languageEnglish (US)
Pages (from-to)254-262
Number of pages9
JournalJournal of Clinical and Translational Hepatology
Issue number2
StatePublished - Apr 2022


  • Intrahepatic cholangiocarcinoma
  • Nomogram
  • Prognostic model
  • Risk stratification

ASJC Scopus subject areas

  • Gastroenterology


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