title: A prognostic scoring system based on clinical features of intrahepatic cholangiocarcinoma: the Fudan score.
abstract: BACKGROUND
  The objectives of this study were to propose a clinical prognostic scoring system applicable for intrahepatic cholangiocarcinoma (ICC) and to evaluate the prognostic validity of the American Joint Committee on Cancer (AJCC) 7th edition staging system.
  
  
  METHODS
  Retrospective univariate and multivariate survival analyses were conducted for 344 patients with ICC who underwent hepatectomy. A simple clinical prognostic scoring system (Fudan score) was developed based on the independent predictors. The prognostic validity was assessed in 74 patients with unresected tumors and compared with the AJCC 6th and 7th edition systems.
  
  
  RESULTS
  In the training set, serum alkaline phosphatase level, carbohydrate antigen 19-9 level, tumor boundary type, tumor size, and number of intrahepatic tumors were independent predictive factors of survival in ICC and were incorporated into the Fudan score. Three hundred forty-four patients were categorized into four subsets with 5-year overall survival rates of 48.6%, 25.6%, 10.3%, and 0.0% for low-, intermediate-, high-, and extremely high-risk groups, respectively. The discriminative ability of the Fudan score was better than that of the AJCC staging system and well applied in the unresected patient set.
  
  
  CONCLUSIONS
  A Fudan score based on clinical factors may provide a relatively accurate prognostic prediction for ICC patients regardless of resection status.
authors.affiliation: Department of Radiation Oncology.
authors.forename: W
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Radiation Oncology. Electronic address: zeng.zhaochong@zs-hospital.sh.cn.
authors.forename: Z-C
authors.initials: ZC
authors.lastname: Zeng
authors.affiliation: Liver Cancer Institute.
authors.forename: Z-Y
authors.initials: ZY
authors.lastname: Tang
authors.affiliation: Liver Cancer Institute.
authors.forename: J
authors.initials: J
authors.lastname: Fan
authors.affiliation: Liver Cancer Institute.
authors.forename: H-C
authors.initials: HC
authors.lastname: Sun
authors.affiliation: Liver Cancer Institute.
authors.forename: J
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Radiology.
authors.forename: M-S
authors.initials: MS
authors.lastname: Zeng
authors.affiliation: Liver Cancer Institute.
authors.forename: B-H
authors.initials: BH
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of Radiation Oncology.
authors.forename: Y-X
authors.initials: YX
authors.lastname: Chen
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000601:surgery; D018395:CA-19-9 Antigen / Q000097:blood; D018281:Cholangiocarcinoma / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D018395:CA-19-9 Antigen; D000469:Alkaline Phosphatase