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Research article
Development and external validation of a nomogram for predicting the effect of tumor size on survival of patients with perihilar cholangiocarcinoma
Xiangcheng Li
First Affiliated Hospital of Nanjing Medical University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background: The effect of tumor size on account of the long-term survival results in perihilar cholangiocarcinoma (PCCA) patients has remained a controversial debate. It is urgent necessary to identify the optimal cutoff value of tumor size in PCCA and integrate tumor size with other prognostic factors into a nomogram to improve the predictive accuracy of the prognosis of patients with PCCA.
Methods: 363 PCCA patients underwent surgical resection were extracted from the Surveillance, Epidemiology and End Results (SEER) database. X-tile program was used to identify the optimal cutoff value of tumor size. A nomogram including tumor size was established to predict 1-, 3- and 5-year cancer-specific survival (CSS) based on the independent risk factors chosen by Kaplan-Meier methods and multivariable cox regression models. The precision of the nomogram for predicting survival was validated internally and externally.
Results: PCCA patients underwent surgical resection were classified into 1-19 mm, 20-33 mm and ³34 mm subgroup based on the optimal cutoff for tumor size in terms of CSS. And we noticed that more larger tumor size group had worse tumor grade, advanced T stage, more positive regional lymph nodes and more frequency vascular invasion. The nomogram according to the independent factors was well calibrated and displayed better discrimination power than 7 th Tumor-Node-Metastasis (TNM) stage systems.
Conclusions: The results demonstrated that the larger the tumor size was, the worse the survival would be. The proposed nomogram, which outperforms the conventional TNM staging system, showed consistently reliability and clinically practicality for predicting the prognosis of PCCA patients.
Keywords
Nomogram, Tumor size, Perihilar cholangiocarcinoma
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CURRENT STATUS: Published
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Posted 28 Sep, 2020
Published
On 30 Oct, 2020
No community comments so far
Editor assigned
On 22 Sep, 2020
Submission checks complete
On 21 Sep, 2020
Editor invited
On 21 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 11 Sep, 2020
Review #2 received
Received 28 Aug, 2020
Reviewer #2 agreed
On 25 Aug, 2020
Review #1 received
Received 11 Jul, 2020
Editor assigned
On 24 Jun, 2020
Reviewers invited
Invitations sent on 24 Jun, 2020
Reviewer #1 agreed
On 24 Jun, 2020
Submission checks complete
On 23 Jun, 2020
Editor invited
On 23 Jun, 2020
No comments provided
Editorial decision: Major revision
On 20 May, 2020
Review #2 received
Received 11 May, 2020
Reviewer #2 agreed
On 20 Apr, 2020
Review #1 received
Received 18 Apr, 2020
Reviewers invited
Invitations sent on 13 Apr, 2020
Reviewer #1 agreed
On 13 Apr, 2020
Editor assigned
On 09 Apr, 2020
Submission checks complete
On 01 Apr, 2020
Editor invited
On 01 Apr, 2020
First submitted
On 30 Mar, 2020
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Development and external validation of a nomogram for predicting the effect of tumor size on survival of patients with perihilar cholangiocarcinoma
Xiangcheng Li
First Affiliated Hospital of Nanjing Medical University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 28 Sep, 2020
Published
On 30 Oct, 2020
No community comments so far
Editor assigned
On 22 Sep, 2020
Submission checks complete
On 21 Sep, 2020
Editor invited
On 21 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 11 Sep, 2020
Review #2 received
Received 28 Aug, 2020
Reviewer #2 agreed
On 25 Aug, 2020
Review #1 received
Received 11 Jul, 2020
Editor assigned
On 24 Jun, 2020
Reviewers invited
Invitations sent on 24 Jun, 2020
Reviewer #1 agreed
On 24 Jun, 2020
Submission checks complete
On 23 Jun, 2020
Editor invited
On 23 Jun, 2020
No comments provided
Editorial decision: Major revision
On 20 May, 2020
Review #2 received
Received 11 May, 2020
Reviewer #2 agreed
On 20 Apr, 2020
Review #1 received
Received 18 Apr, 2020
Reviewers invited
Invitations sent on 13 Apr, 2020
Reviewer #1 agreed
On 13 Apr, 2020
Editor assigned
On 09 Apr, 2020
Submission checks complete
On 01 Apr, 2020
Editor invited
On 01 Apr, 2020
First submitted
On 30 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background: The effect of tumor size on account of the long-term survival results in perihilar cholangiocarcinoma (PCCA) patients has remained a controversial debate. It is urgent necessary to identify the optimal cutoff value of tumor size in PCCA and integrate tumor size with other prognostic factors into a nomogram to improve the predictive accuracy of the prognosis of patients with PCCA.
Methods: 363 PCCA patients underwent surgical resection were extracted from the Surveillance, Epidemiology and End Results (SEER) database. X-tile program was used to identify the optimal cutoff value of tumor size. A nomogram including tumor size was established to predict 1-, 3- and 5-year cancer-specific survival (CSS) based on the independent risk factors chosen by Kaplan-Meier methods and multivariable cox regression models. The precision of the nomogram for predicting survival was validated internally and externally.
Results: PCCA patients underwent surgical resection were classified into 1-19 mm, 20-33 mm and ³34 mm subgroup based on the optimal cutoff for tumor size in terms of CSS. And we noticed that more larger tumor size group had worse tumor grade, advanced T stage, more positive regional lymph nodes and more frequency vascular invasion. The nomogram according to the independent factors was well calibrated and displayed better discrimination power than 7 th Tumor-Node-Metastasis (TNM) stage systems.
Conclusions: The results demonstrated that the larger the tumor size was, the worse the survival would be. The proposed nomogram, which outperforms the conventional TNM staging system, showed consistently reliability and clinically practicality for predicting the prognosis of PCCA patients.
Figure 1
Figure 2
Figure 3
Figure 4