Survival Outcomes of Preoperative Serum Biomarkers in Patients With Surgically Treated Intrahepatic Cholangiocarcinoma.

INTRODUCTION

Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumor, often diagnosed at advanced stages, with recurrence and metastasis significantly affecting survival. The combined prognostic value of biomarkers such as the Systemic Immune-Inflammation Index (SII), Fibrosis-4 (FIB-4), and Prognostic Nutritional Index (PNI) remains underexplored.

METHODS

A retrospective analysis of 280 patients with ICC who underwent curative resection was performed. The prognostic significance of FIB-4, SII, and PNI for overall survival (OS) and disease-free survival (DFS) was assessed using clinical, pathological, and follow-up data. Statistical analysis included Cox regression and Kaplan-Meier survival curves.

RESULTS

High PNI was significantly associated with better OS ( P = 0.014) and DFS ( P = 0.025). High FIB-4 levels correlated with worse OS ( P = 0.0076) and DFS ( P = 0.023). High SII was strongly associated with poor OS ( P < 0.0001) and DFS ( P = 0.00041). The combination of high SII, low PNI, and high FIB-4 was linked to significantly worse OS (hazard ratios = 2.633, P = 0.002) and DFS (hazard ratios = 2.475, P = 0.004).

DISCUSSION

Preoperative serum biomarkers, including PNI, FIB-4, and SII, are significant independent prognostic factors for patients with ICC. Their combined use may help refine prognostic assessment and guide personalized treatment strategies.