DataSheet_1_Tumor burden score dictates prognosis of patients with combined hepatocellular cholangiocarcinoma undergoing hepatectomy.pdf

BackgroundThe prognostic value of the tumor burden score (TBS) in patients with combined hepatocellular-cholangiocarcinoma (cHCC-CCA) remains unknown. This study aimed to investigate the impact of TBS on long-term outcomes after surgery.
MethodsPatients who underwent radical-intent resection between June 2013 and December 2019 were retrospectively reviewed. Kaplan–Meier curves were used to analyze patient survival, and disease-free survival (DFS) and overall survival (OS) were examined in relation to TBS.
ResultsA total of 178 patients were included in this study, with 119 in the training cohort and 59 in the validation cohort. Kaplan–Meier curves showed that TBS was a strong prognostic indicator in patients with cHCC-CCA. Elevated TBS was associated with poorer DFS and OS (both P-value < 0.001) and was identified as an independent prognostic indicator. In addition, the prognostic value of TBS outperformed tumor size and number alone, microvascular invasion, and lymph node invasion. The prognostic significance of TBS was confirmed by the internal validation cohort.
ConclusionsThe present study suggested the significance of tumor morphology in assessing the prognosis of patients with cHCC-CCA who undergoing curative resection. The TBS is a promising prognostic index in patients with cHCC-CCA. Elevated TBS was related to a lower long-term survival rate and was identified as an independent risk factor for poor DFS and OS. Further research is needed to verify our results.

背景 肿瘤负荷评分（tumor burden score, TBS）在混合型肝细胞胆管细胞癌（combined hepatocellular-cholangiocarcinoma, cHCC-CCA）患者中的预后价值尚未明确。本研究旨在探讨TBS对术后远期预后的影响。
方法 对2013年6月至2019年12月期间接受根治性切除术的患者进行回顾性分析。采用Kaplan-Meier曲线分析患者生存情况，并探讨肿瘤负荷评分与无病生存期（disease-free survival, DFS）、总生存期（overall survival, OS）的相关性。
结果 本研究共纳入178例患者，其中训练队列119例，验证队列59例。Kaplan-Meier曲线分析显示，TBS可作为cHCC-CCA患者的可靠预后指标。较高的TBS水平与更差的无病生存期和总生存期显著相关（两者P值均<0.001），且TBS被证实为独立预后指标。此外，TBS的预后价值优于单纯肿瘤大小、肿瘤数量、微血管侵犯及淋巴结侵犯。内部验证队列进一步验证了TBS的预后意义。
结论 本研究提示，肿瘤形态学特征在评估接受根治性切除术的cHCC-CCA患者预后中具有重要价值。TBS是cHCC-CCA患者颇具前景的预后评估指标。较高的TBS水平与更低的远期生存率相关，且被确定为无病生存期和总生存期不良的独立危险因素。未来仍需开展进一步研究以验证本研究结果。