A model for predicting post-liver transplantation recurrence in intrahepatic cholangiocarcinoma recipients

Background: It is important to select appropriate patients for improving the outcomes of liver transplantation for intrahepatic cholangiocarcinoma (iCCA). The objective of this study was to establish a predictive model for the recurrence of iCCA after liver transplantation. Methods: Twenty-one patients who received liver transplantation for iCCA were used to construct a model for predicting recurrence. Predictors of recurrence were tested by a Cox model analysis. The results were validated in 28 patients who were followed up. Results: Diameter and number of tumors, and CA19-9 level independently predicted tumor recurrence. At a Cox score threshold of 0.736 [95% confidence interval (CI): 0.549-0.923], a model combining these factors was highly predictive of tumor recurrence and death. A simplified version of the model identified a cut-off value of 6. The 5-year OS rate was lower in patients with a score >6 points compared to those with a score <= 6 points (P=0.005). The 5-year recurrence rate was higher in patients with a score >6 points as compared to those with a score 5.6 points (P=0.034). Conclusions: The model developed was useful for predicting recurrence of iCCA after liver transplantation. Large sample, multicenter studies are needed to validate the findings.