Wang et al developed a nomogram for evaluating a patient with cholangiocarcinoma treated with partial hepatectomy. This may help to identify a patient who may benefit from more aggressive management. The authors
Patient selection: status post partial hepatectomy for cholangiocarcinoma
Parameters:
(1) preoperative serum CEA in µg/L
(2) preoperative serum CA19-9 in U/mL
(3) vascular invasion
(4) lymph node metastases
(5) direct invasion and/or local metastases
(6) number of tumor nodules
(7) diameter
points for serum CEA =
= MIN(63.3,((serum CEA)*0.633))
points for serum CA19-9 =
= MIN(34.6,((serum CA19-9)*0.0346))
points for tumor diameter =
= MIN(91.4,((diameter in cm)*4.155))
|
Parameter |
Finding |
Points |
|
vascular invasion |
no |
0 |
|
|
yes |
26.3 |
|
lymph node metastases |
no |
0 |
|
|
yes |
40 |
|
direct invasion, local metastasis |
no |
0 |
|
|
yes |
26 |
|
number of tumor nodules |
1 |
0 |
|
|
2 or 3 |
25.4 |
|
|
4 or more |
100 |
|
|
periductal infiltrating type |
100 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: over 400
• The higher the score the worse the long-term survival.
|
Score |
5 Year Survival |
|
< 8.5 |
> 65% |
|
8.5 to 65.7 |
(-0.001645 * ((points)^2)) - (0.4954 * (points)) + 69.5 |
|
65.7 to 116.4 |
(0.003692 * ((points)^2)) - (1.17 * (points)) + 91.04 |
|
> 116.4 |
< 5% |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
ICD-10: ,
