Zhonghua wai ke za zhi [Chinese journal of surgery]最新文献

{"title":"[Current status and thought of transcatheter mitral edge-to-edge repair in the treatment of hypertrophy cardiomyopathy].","authors":"P J Wei,&nbsp;F W Zhang,&nbsp;X B Pan","doi":"10.3760/cma.j.cn112139-20221018-00449","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20221018-00449","url":null,"abstract":"<p><p>Septal reduction therapies, which include septal myectomy and alcohol septal ablation and so on, are the current treatment strategies for patients with obstructive hypertrophic cardiomyopathy and drug-refractory symptoms. With the deepening of theoretical understanding and the rapid development of interventional therapies, some researchers have tried to perform transcatheter mitral valve edge-to-edge repair to treat high-risk patients with hypertrophic cardiomyopathy, including obstructive and non-obstructive. The reported results are relatively satisfactory, but many urgent problems need to be solved, such as the lack of data on animal experiments and large cohort studies, and the unknown medium- and long-term outcomes. However, transcatheter mitral valve edge-to-edge repair brings new ideas for the diagnosis and treatment of patients with hypertrophic cardiomyopathy. On one hand, it can be used as a monotherapy, on the other hand, it can be combined with novel molecular targeted drug therapy or emerging minimally invasive surgical procedures targeting hypertrophic ventricular septum, which deserves our further attention and exploratory research.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 3","pages":"196-200"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgery for obstructive hypertrophic cardiomyopathy: challenge and future].","authors":"H M Guo,&nbsp;P J Wei","doi":"10.3760/cma.j.cn112139-20220918-00397","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20220918-00397","url":null,"abstract":"<p><p>After more than 60 years of development, with the deepening of the pathophysiological understanding of obstructive hypertrophic cardiomyopathy, the extent and resection thickness of myectomy have increased significantly. Myectomy combined with the correction of anomalies of the mitral valve apparatus has become the standard treatment of obstructive hypertrophic cardiomyopathy. Only a few centers worldwide can routinely perform it due to the difficulty. Because of the advances of new drugs and interventional therapy, the development of surgical treatment faces many challenges. At the same time, generations of cardiovascular surgeons are constantly trying to promote septal myectomy, including developing devices and the surgical field, as well as improving surgical planning by advanced technology. At present, the superior long-term efficacy of septal myectomy has been confirmed. It is necessary to work together to promote the treatment of hypertrophic obstructive cardiomyopathy, so as to guard people's health.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 3","pages":"181-186"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9457396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The progression of the extent of lymph node dissection in radical resection of pancreatic head cancer].","authors":"J H Chen, C Y Jiang","doi":"10.3760/cma.j.cn112139-20220511-00216","DOIUrl":"10.3760/cma.j.cn112139-20220511-00216","url":null,"abstract":"<p><p>Pancreatic cancer is a malignant tumor of digestive system with poor prognosis,and surgical resection is still the only hope for a radical cure. Although the current consensus and guidelines describe in detail the standard and extended range of lymph node dissection,the selection of specific range of lymph node dissection and its impact on prognosis are still controversial. Current studies have not only proposed some improved extent of lymph node dissection, such as total mesopancreas excision and Heidelberg triangle dissection, but also suggested different extent of lymph node dissection for ventral and dorsal pancreatic head cancer. In addition, the prognosis of pancreatic head cancer in uncinate process and non-uncinate process is different after para-aortic lymph node dissection, which is worthy of further study. Neoadjuvant therapy or conversion therapy provides more surgical opportunities for patients with pancreatic cancer. For these patients, Heidelberg triangle dissection has potential value in improving prognosis. This paper summarizes the exploration and latest progress of standard and extended lymph node dissection, lymph node dissection of specific site of pancreatic head cancer and the extent of lymph node dissection after neoadjuvant/transformation therapy in recent years.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 3","pages":"251-255"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The relationship between the characteristics of tears and the progression of Stanford type B aortic dissection after endovascular treatment].","authors":"P F Yuan,&nbsp;M W Wu,&nbsp;H B Wang,&nbsp;J Xiong","doi":"10.3760/cma.j.cn112139-20220823-00364","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20220823-00364","url":null,"abstract":"<p><p>Endovascular treatment of Stanford type B aortic dissection (type B dissection) has been widely used. There will be complications such as aortic dilatation, which will lead to poor prognosis of some patients. With more in-depth researches, it was found that there was a possible correlation between the prognosis of type B dissection and tears, such as the increasing of aortic diameter would be faster with longer tears, and the location of the tear will affect the thrombosis of the false lumen. Studies on hemodynamics have also found that different characteristics of tears of aortic dissection can cause changes in the pressure, blood flow rate and blood capacity in the true and false lumens recently. The hemodynamic changes can be used to predict the prognosis of type B dissection. The main characteristics of tears included the size, position, number of tears, residual tears and stent graft induced new entry. Describing the effect of tear characteristics on the development of type B dissection, can provide the basis for the clinical treatment and further research of type B dissection.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 3","pages":"256-259"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10819232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A comparison of current guidelines for the management of intrahepatic cholangiocarcinoma worldwide].","authors":"Y X Yu, Z J Wu, W Tang, R Liao","doi":"10.3760/cma.j.cn112139-20221125-00495","DOIUrl":"10.3760/cma.j.cn112139-20221125-00495","url":null,"abstract":"<p><p>Intrahepatic cholangiocarcinoma (ICC) is the second most common human liver malignancy and its incidence rate has been gradually increasing worldwide over the past decades. Surgical resection (R0 resection) is the preferred potentially curative treatment for ICC patients. However, due to its conceal clinical features and high invasiveness, most patients have lost the opportunity for surgical resection at the time of diagnosis. In recent years, with the rapid development of targeted therapy and immunotherapy, which is represented by immune checkpoint inhibitors, clinicians are expected to provide more effective treatment options for patients with mid-stage or advanced ICC. At present, there are still controversial opinions on different guidelines regarding preoperative biliary drainage, the extent of hepatectomy, the definition of R0 resection, the width of the resection margin, lymph node dissection, postoperative recurrence, adjuvant therapy, etc. In this review, 12 guidelines or expert consensus published worldwide from 2012 to 2022 (including 4 Chinese guidelines, 4 European guidelines, 2 American guidelines and 2 Japanese guidelines) were retrieved. Focusing on sorting and comparing the current views on clinical management of ICC in different guidelines, this review aims to provide reference information for ICC clinical management and decision-making.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"297-304"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A nomogram for preoperative prediction of lymph node metastasis in patients with intrahepatic cholangiocarcinoma based on inflammation-related markers].","authors":"X P Yu, J L Chen, Y Tang, C Chen, Y H Qiu, H Wu, T Q Song, Y He, X H Mao, W L Zhai, Z J Cheng, X Liang, J D Li, C D Sun, K Ma, R X Lin, Z M Geng, Z H Tang, Z W Quan","doi":"10.3760/cma.j.cn112139-20230106-00009","DOIUrl":"10.3760/cma.j.cn112139-20230106-00009","url":null,"abstract":"<p><p><b>Objectives:</b> To construct a nomogram for prediction of intrahepatic cholangiocarcinoma (ICC) lymph node metastasis based on inflammation-related markers,and to conduct its clinical verification. <b>Methods:</b> Clinical and pathological data of 858 ICC patients who underwent radical resection were retrospectively collected at 10 domestic tertiary hospitals in China from January 2010 to December 2018. Among the 508 patients who underwent lymph node dissection,207 cases had complete variable clinical data for constructing the nomogram,including 84 males,123 females,109 patients≥60 years old,98 patients<60 years old and 69 patients were pathologically diagnosed with positive lymph nodes after surgery. Receiver operating characteristic curve was drawn to calculate the accuracy of preoperative imaging examinations to determine lymph node status,and the difference in overall survival time was compared by Log-rank test. Partial regression squares and statistically significant preoperative variables were screened by backward stepwise regression analysis. R software was applied to construct a nomogram,clinical decision curve and clinical influence curve,and Bootstrap method was used for internal verification. Moreover,retrospectively collecting clinical information of 107 ICC patients with intraoperative lymph node dissection admitted to 9 tertiary hospitals in China from January 2019 to June 2021 was for external verification to verify the accuracy of the nomogram. 80 patients with complete clinical data but without lymph node dissection were divided into lymph node metastasis high-risk group and low-risk group according to the score of the nomogram among the 858 patients. Log-rank test was used to compare the overall survival of patients with or without lymph node metastasis diagnosed by pathology. <b>Results:</b> The area under the curve of preoperative imaging examinations for lymph node status assessment of 440 patients was 0.615,with a false negative rate of 62.8% (113/180) and a false positive rate of 14.2% (37/260). The median survival time of 207 patients used to construct a nomogram with positive or negative postoperative pathological lymph node metastases was 18.5 months and 27.1 months,respectively (<i>P</i><0.05). Five variables related to lymph node metastasis were screened out by backward stepwise regression analysis,which were combined calculi,neutrophil/lymphocyte ratio,albumin,liver capsule invasion and systemic immune inflammation index,according to which a nomogram was constructed with concordance index(C-index) of 0.737 (95%<i>CI</i>: 0.667 to 0.806). The C-index of external verification was 0.674 (95%<i>CI</i>:0.569 to 0.779). The calibration prediction curve was in good agreement with the reference curve. The results of the clinical decision curve showed that when the risk threshold of high lymph node metastasis in the nomogram was set to about 0.32,the maximum net benefit could be obtained by 0.11,and the cost/benefit r","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"321-329"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of postoperative adjuvant chemotherapy on prognosis of patients with intrahepatic cholangiocarcinoma:a multicenter retrospective study].","authors":"Q Z Lin, H Z Liu, W P Zhou, Z J Cheng, J Y Lou, S G Zheng, X Y Bi, J M Wang, W Guo, F Y Li, J Wang, Y M Zheng, J D Li, S Cheng, Y Y Zeng","doi":"10.3760/cma.j.cn112139-20230106-00010","DOIUrl":"10.3760/cma.j.cn112139-20230106-00010","url":null,"abstract":"<p><p><b>Objectives:</b> To examine the influence of adjuvant chemotherapy after radical resection on the survival of patients with intrahepatic cholangiocarcinoma(ICC) and to identify patients who may benefit from it. <b>Methods:</b> The clinical and pathological data of 654 patients with ICC diagnosed by postoperative pathology from December 2011 to December 2017 at 13 hospitals in China were collected retrospectively. According to the inclusion and exclusion criteria,455 patients were included in this study,including 69 patients (15.2%) who received adjuvant chemotherapy and 386 patients (84.8%) who did not receive adjuvant chemotherapy. There were 278 males and 177 females,with age of 59 (16) years (<i>M</i>(IQR))(range:23 to 88 years). Propensity score matching (PSM) method was used to balance the difference between adjuvant chemotherapy group and non-adjuvant chemotherapy group. Kaplan-Meier method was used to plot the survival curve,the Log-rank test was used to compare the difference of overall survival(OS) and recurrence free survival(RFS)between the two groups. Univariate analysis was used to determine prognostic factors for OS. Multivariate Cox proportional hazards models were then performed for prognostic factors with <i>P</i><0.10 to identify potential independent risk factors. The study population were stratified by included study variables and the AJCC staging system,and a subgroup analysis was performed using the Kaplan-Meier method to explore the potential benefit subgroup population of adjuvant chemotherapy. <b>Results:</b> After 1∶1 PSM matching,69 patients were obtained in each group. There was no significant difference in baseline data between the two groups (all <i>P</i>>0.05). After PSM,Cox multivariate analysis showed that lymph node metastasis (<i>HR</i>=3.06,95%<i>CI</i>:1.52 to 6.16,<i>P</i>=0.039),width of resection margin (<i>HR</i>=0.56,95%<i>CI</i>:0.32 to 0.99,<i>P</i>=0.044) and adjuvant chemotherapy (<i>HR</i>=0.51,95%<i>CI</i>:0.29 to 0.91,<i>P</i>=0.022) were independent prognostic factors for OS. Kaplan-Meier analysis showed that the median OS time of adjuvant chemotherapy group was significantly longer than that of non-adjuvant chemotherapy group (<i>P</i><0.05). There was no significant difference in RFS time between the adjuvant chemotherapy group and the non-adjuvant chemotherapy group (<i>P</i>>0.05). Subgroup analysis showed that,the OS of female patients,without HBV infection,carcinoembryonic antigen<9.6 μg/L,CA19-9≥200 U/ml,intraoperative bleeding<400 ml,tumor diameter>5 cm,microvascular invasion negative,without lymph node metastasis,and AJCC stage Ⅲ patients could benefit from adjuvant chemotherapy (all <i>P</i><0.05). <b>Conclusion:</b> Adjuvant chemotherapy can prolong the OS of patients with ICC after radical resection,and patients with tumor diameter>5 cm,without lymph node metastasis,AJCC stage Ⅲ,and microvascular invasion negative are more likely to benefit from adjuvant chemotherapy.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"305-312"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical management of choledochal cyst: status quo and hot issues].","authors":"X Wang, Y J Zhang","doi":"10.3760/cma.j.cn112139-20221121-00486","DOIUrl":"10.3760/cma.j.cn112139-20221121-00486","url":null,"abstract":"<p><p>Choledochal cyst is one of the most common congenital diseases in biliary tract system,which can affect children as well as adults. While the surgical management has markedly evolved in recent years,our understanding related to the nomenclature,diagnosis and classification of choledochal cysts remains to be inadequate. Anatomic variations and intrahepatic bile duct stricture are prone to be overlooked during surgery. Besides,it is still controversial in the treatment of intrapancreatic choledochal cyst and the extent of resection related to intrahepatic dilated bile ducts. Along with the advancement of laparoscopic or robot-assisted procedures,there is also an increased number of reoperations for patients with choledochal cyst,which underscores the importance of long-term biliary patency. This state-of-the-art review on choledochal cyst aims to further improve the diagnosis and treatment for this benign but intractable disease.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"283-290"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of safety and efficacy of laparoscopic surgery for gallbladder carcinoma].","authors":"X Wu, T G Xie, B L Li, C J Zheng, X D He, W Liu, T Hong","doi":"10.3760/cma.j.cn112139-20221225-00543","DOIUrl":"10.3760/cma.j.cn112139-20221225-00543","url":null,"abstract":"<p><p><b>Objective:</b> To examine the efficacy and safety of laparoscopic surgery for gallbladder carcinoma. <b>Methods:</b> The data of 197 gallbladder carcinoma patients admitted at Peking Union Medical College Hospital between January 2012 and September 2022 were analyzed retrospectively. There were 86 males and 111 females,with age of (64.4±9.8)years(range:35 to 89 years). Patients were divided into laparoscopic group(<i>n</i>=53) and open group(<i>n</i>=144) according to different surgical methods. The general information of the two groups were matched by propensity score matching,and the clinical data and prognosis were compared between the two groups. Categorical variables were analyzed using χ² test or Fisher's exact test,as appropriate. Continuous variables with and without normal distribution were analyzed using <i>t</i>-test and Mann-Whitney <i>U</i> test,respectively. Kaplan-Meier curves with Log-rank test were used to analyze the cumulative survival rates. <b>Results:</b> Forty-eight pairs of patients were matched successfully. There was no difference in general information,cholecystolithiasis,partial hepatectomy,and tumor stage between two groups(all <i>P</i>>0.05). The laparoscopic group had shorter operation time(<i>t</i>=-3.987,<i>P</i><0.01),less bleeding(<i>Z</i>=-4.862,<i>P</i><0.01),shorter total(<i>Z</i>=-5.009,<i>P</i><0.01) and postoperative(<i>Z</i>=-5.412,<i>P</i><0.01) hospital stay. Seventeen patients had postoperative complications. According to the Clavien-Dindo system,there were 4,11,1,and 1 patient with grade Ⅰ,Ⅱ,Ⅲa,and Ⅲb,respectively. All complications were improved after active treatment. After a median follow-up of 24(36) months(range:3 to 130 months),56 patients(58.3%) survived without tumor,7 patients(7.3%) survived with tumor,and 33 patients(34.4%) died. According to the Kaplan-Meier curves,there was no significant difference between laparoscopic and open groups in disease free(χ²=0.399,<i>P</i>=0.528) and overall(χ²=0.672,<i>P</i>=0.412) survival rates. <b>Conclusions:</b> The laparoscopic surgery is safe and effective in selected patients with gallbladder carcinoma. It can reduce surgical trauma and enhance patient recovery without increasing complication. Its prognosis is similar to that of open surgery.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"330-335"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Survival analysis of patients with intrahepatic cholangiocarcinoma treated with adjuvant chemotherapy after radical resection based on CoxPH model and deep learning algorithm].","authors":"J L Chen, X P Yu, Y Tang, C Chen, Y H Qiu, H Wu, T Q Song, Y He, X H Mao, W L Zhai, Z J Cheng, J D Li, Z M Geng, Z H Tang, Z W Quan","doi":"10.3760/cma.j.cn112139-20230105-00007","DOIUrl":"10.3760/cma.j.cn112139-20230105-00007","url":null,"abstract":"<p><p><b>Objective:</b> To establish a predictive model for survival benefit of patients with intrahepatic cholangiocarcinoma (ICC) who received adjuvant chemotherapy after radical resection. <b>Methods:</b> The clinical and pathological data of 249 patients with ICC who underwent radical resection and adjuvant chemotherapy at 8 hospitals in China from January 2010 to December 2018 were retrospectively collected. There were 121 males and 128 females,with 88 cases>60 years old and 161 cases≤60 years old. Feature selection was performed by univariate and multivariate Cox regression analysis. Overall survival time and survival status were used as outcome indicators,then target clinical features were selected. Patients were stratified into high-risk group and low-risk group,survival differences between the two groups were analyzed. Using the selected clinical features, the traditional CoxPH model and deep learning DeepSurv survival prediction model were constructed, and the performance of the models were evaluated according to concordance index(C-index). <b>Results:</b> Portal vein invasion, carcinoembryonic antigen>5 μg/L,abnormal lymphocyte count, low grade tumor pathological differentiation and positive lymph nodes>0 were independent adverse prognostic factors for overall survival in 249 patients with adjuvant chemotherapy after radical resection (all <i>P</i><0.05). The survival benefit of adjuvant chemotherapy in the high-risk group was significantly lower than that in the low-risk group (<i>P</i><0.05). Using the above five features, the traditional CoxPH model and the deep learning DeepSurv survival prediction model were constructed. The C-index values of the training set were 0.687 and 0.770, and the C-index values of the test set were 0.606 and 0.763,respectively. <b>Conclusion:</b> Compared with the traditional Cox model, the DeepSurv model can more accurately predict the survival probability of patients with ICC undergoing adjuvant chemotherapy at a certain time point, and more accurately judge the survival benefit of adjuvant chemotherapy.</p>","PeriodicalId":23966,"journal":{"name":"Zhonghua wai ke za zhi [Chinese journal of surgery]","volume":"61 4","pages":"313-320"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10769103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}