Prognostic nomogram for cholangiocarcinoma after immunotherapy

Abstract

Abstract Purpose: We aim to establish a convenient and effective prognostic nomogram for cholangiocarcinoma (CCA) patients receiving immunotherapy, and to further help the selection of individualized treatment regimens. Patients and Methods: We retrospectively analyzed the clinicopathological and follow-up data of CCA patients who underwent immunotherapy from January 2020 to December 2022 at Nanjing Drum Tower Hospital and Jinling Hospital. The univariate and multivariate Cox regression analyses were used to assess the relationship between variables and survival data. A novel prognostic nomogram was established, and the discrimination ability, accuracy, and clinical applicability of the nomogram were measured by concordance index (C-index), calibration curves, and decision curve analysis (DCA). Results： A total of 60 patients were enrolled in this study. Univariate and multivariate analyses identified that liver metastasis, surgery, and Eastern Cooperative Oncology Group performance status (ECOG PS) were independent prognostic factors for CCA patients after immunotherapy. The nomogram was then established based on the above factors, the C-index of nomogram was 0.814 [(95% confidence interval (CI): 0.720-0.908)], the area under the curve (AUC) values in the 6, 9, and 12 months were 0.870 (95% CI: 0.760-0.979), 0.882 (95% CI: 0.769-0.996), and 0.902 (95% CI: 0.769-0.996), respectively. Calibration curves showed good consistency between the nomogram predicted and actual observed, and DCA further suggested good clinical applicability of the nomogram. Conclusion: The nomogram we established showed good performance in predicting survival benefits in patients with CCA after immunotherapy. This prognostic model may help us to select individualized treatment.