Constructing and validating a novel nomogram based on nutritional biomarkers to predict prognosis postresection intrahepatic cholangiocarcinoma cases

Abstract Background: The intent of this study is to construct a novel nomogram using the psoas muscle index (PMI) and prognostic nutritional indexes (PNI) to identify high-risk intrahepatic cholangiocarcinoma postresection cases. Methods: In total, 178 patients with intrahepatic cholangiocarcinoma after hepatectomy in multiple hospitals between August 2012 and October 2019 were enrolled. Kaplan–Meier analysis revealed the overall survival and recurrence-free survival. Univariate and multivariate Cox regression analyses were performed to screen for the risk factors for overall and recurrence-free survival. A nomogram was established to predict the prognoses of patients with intrahepatic cholangiocarcinoma. Results: A total of 178 patients with intrahepatic cholangiocarcinoma were included. The overall survival was worse for patients with low psoas muscle and prognostic nutritional indexes combined (P < 0.01). The psoas muscle index, prognostic nutritional index, lymph node metastasis, and tumor differentiation were used to establish the nomogram. The area under the receiver operating characteristic curve (AUC) for the nomogram’s 1-, 3-, and 5-years predicted survival was 0.721, 0.777, and 0.752, respectively. Similarly, we verified the model’s satisfactory applicability through recurrence-free survival (AUC = 0.690, 0.784, and 0.744). The dichloroacetate curves revealed that the overall and recurrence-free survival models had clinical benefits. In addition, the difference between the patients at high and low risk was significant (P < 0.001). Conclusion: Our nomogram, using the psoas muscle and prognostic nutritional indexes, can identify patients with intrahepatic cholangiocarcinoma with the highest risk of poor prognosis and helps to improve poor prognosis.