Morbidity, Prognostic Factors, and Competing Risk Nomogram for Combined Hepatocellular-Cholangiocarcinoma

作者：Xiaoyuan Chen, Yiwei Lu, Xiaoli Shi, Xuejiao Chen, Dawei Rong, Guoyong Han, Long Zhang, Chuangye Ni, Jie Zhao, Yun Gao, Xuehao Wang · 发表于：Journal of Oncology · 年份：2021 · DOI：10.1155/2021/3002480 · 被引用次数：7 · 研究领域：Cholangiocarcinoma and Gallbladder Cancer Studies、Hepatocellular Carcinoma Treatment and Prognosis、Gallbladder and Bile Duct Disorders

Background. Combined hepatocellular-cholangiocarcinoma (CHC) is a rare and heterogeneous histological subtype of primary liver cancer, which is still poorly understood. This study aimed to describe the epidemiological and clinical features, investigate the prognostic indicators, and develop a competing risk nomogram for CHC. Methods. The study cohort was taken from the Surveillance, Epidemiology, and End Results database. The annual percent change (APC) in incidence was calculated using the joinpoint regression. The nomogram was developed based on multivariate competing risk survival analyses and validated by calibration curves. Akaike information criterion, Bayesian information criterion, Harrell’s C-index, and area under the receiver operating characteristic curves were obtained to compare prognostic performance. Decision curve analysis was introduced to examine the clinical value of the models. Results. The overall incidence of CHC was 0.062 per 100,000 individuals in 2004 and 0.081 per 100,000 individuals in 2018, with an APC of 1.0% ( P > 0.05 ). CHC displayed intermediate clinicopathological features of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Race, tumor size, vascular invasion, extrahepatic invasion, distant metastasis, grade, surgery, and Metavir stage were confirmed as the independent predictors of cancer-specific survival. The constructed nomogram was well calibrated, which showed better discrimination power and higher net benefits...