Lymph Node Ratio Nomogram-Based Prognostic Model for Resected Distal Cholangiocarcinoma.

Area of Science:

• Surgical Oncology
• Gastroenterology
• Cancer Research

Background:

• Distal cholangiocarcinoma (dCC) prognosis is influenced by factors like lymph node metastases and lymph node ratio (LNR).
• Accurate prediction of recurrence-free survival (RFS) is crucial for managing resected dCC.
• Existing prognostic models require refinement for dCC patient stratification.

Purpose of the Study:

• To evaluate the prognostic value of LNR for RFS in resected dCC.
• To develop and validate a novel prognostic nomogram for predicting RFS in dCC patients.
• To identify independent prognostic factors for RFS in dCC.

Main Methods:

• Retrospective analysis of 415 patients undergoing pancreaticoduodenectomy (PD) for dCC across 10 centers.
• Multivariate Cox regression analysis to identify independent prognostic factors for RFS.
• Development and assessment of a prognostic nomogram using the concordance index (C-index).

Main Results:

• LNR (≥15), perineural invasion, differentiation grade, and radicality of PD were independent prognostic factors for RFS.
• The developed nomogram demonstrated a high predictive performance with a C-index of 0.8.
• LNR ≥15 significantly impacted RFS (HR 2.442, p=0.003).

Conclusions:

• LNR demonstrates high prognostic efficiency for RFS in resected dCC.
• The novel nomogram, incorporating LNR, provides accurate prognosis assessment for dCC patients.
• This tool can aid in personalized treatment strategies and patient counseling for dCC.