Abstract: Objective To explore the prognostic factors after radical resection of intrahepatic cholangiocarcinoma(ICC)and to establish a nomogram to predict postoperative overall survival. Methods The clinicopathological data of 79 ICC patients who underwent radical resection in our hospital during Jul. 2009 and Oct. 2017 were collected. The impacts of clinicopathological characteristics on overall survival and recurrence-free survival were analyzed with Kaplan-Meier and Cox regression models. A survival nomogram was established with R software(version 4.0.1), and the predictive performance of the nomogram was verified with C-index, calibration curve and area under ROC curve(AUC). Results The 1-year, 2-year, and 3-year cumulative recurrence-free survival rates were 43.0%, 26.6% and 20.3%, respectively. The median survival time was 15 months, and the 1-year, 2-year, and 3-year cumulative overall survival rates were 63.3%, 41.8% and 27.8%, respectively. Multivariate analysis demonstrated that CA19-9, lymphovascular invasion and multiple tumors were independent risk factors of overall survival. CA19-9, multiple tumors and differentiation of tumors were independent risk factors of recurrence. The C-index was 0.723(95%CI: 0.66-0.79), and the AUC of 1-year, 2-year, and 3-year survival rates were 0.78(95%CI: 0.68-0.89), 0.85(95%CI: 0.77-0.93), and 0.77(95%CI: 0.67-0.87), respectively. Conclusion ICC has a poor prognosis and low postoperative survival rate. The early symptoms are atypical. CA19-9 and multiple tumors are independent risk factors for both survival and recurrence. The internally validated nomogram can predict the survival rates.

Key words: Intrahepatic cholangiocarcinoma, Survival analysis, Prognostic factors, Nomogram, Recurrence