Prediction of overall survival in resectable intrahepatic cholangiocarcinoma: ISICC‐applied prediction model

• Published in: Cancer science Vol. 111; no. 4; pp. 1084 - 1092
• Main Authors: Tian, Mengxin, Liu, Weiren, Tao, Chenyang, Tang, Zheng, Zhou, Yufu, Song, Shushu, Jin, Lei, Wang, Han, Jiang, Xifei, Zhou, Peiyun, Fang, Yuan, Qu, Weifeng, Ding, Zhenbin, Peng, Yuanfei, Fu, Xiutao, Qiu, Shuangjian, Zhou, Jian, Fan, Jia, Shi, Yinghong
• Format: Journal Article
• Language: English
• Published: Hoboken John Wiley and Sons Inc 01-04-2020
• Subjects: immune‐infiltrating cells; intrahepatic cholangiocarcinoma; liver cancer; Original; prognosis; survival prediction
• ISSN: 1347-9032; 1349-7006
• DOI: 10.1111/cas.14315

Intrahepatic cholangiocarcinoma (ICC) remains a highly heterogeneous disease with poor prognosis. Tumor‐infiltrating lymphocytes were predictive in various cancers, but their prognostic value in ICC is less clear. A total of 168 ICC patients who had received liver resection were enrolled and assigned to the derivation cohort. Sixteen immune markers in tumor and peritumor regions were examined by immunohistochemistry. A least absolute shrinkage and selection operator model was used to identify prognostic markers and to establish an immune signature for ICC (ISICC). An ISICC‐applied prediction model was built and validated in another independent dataset. Five immune features, including CD3peritumor (P), CD57P, CD45RAP, CD66bintratumoral (T) and PD‐L1P, were identified and integrated into an individualized ISICC for each patient. Seven prognostic predictors, including total bilirubin, tumor numbers, CEA, CA19‐9, GGT, HBsAg and ISICC, were integrated into the final model. The C‐index of the ISICC‐applied prediction model was 0.719 (95% CI, 0.660‐0.777) in the derivation cohort and 0.667 (95% CI, 0.581‐0.732) in the validation cohort. Compared with the conventional staging systems, the new model presented better homogeneity and a lower Akaike information criteria value in ICC. The ISICC‐applied prediction model may provide a better prediction performance for the overall survival of patients with resectable ICC in clinical practice.
Using tissue microarray, we examined the density of 16 immune biomarkers in 280 ICC patients who underwent hepatectomy, and established a novel ISICC‐based prediction model (IPM) to predict patients’ overall survival with bilirubin, tumor numbers, CEA, CA19‐9, γ‐glutamyl transferase (GGT), HBsAg and ISICC. The new model may provide a better prediction performance for the overall survival of patients with resectable ICC in clinical practice.