Abstract
BACKGROUND: Serum lipid levels have been associated with the prognosis of various malignancies. AIM: To develop a novel nomogram based on serum lipid parameters to predict overall survival in patients with intrahepatic cholangiocarcinoma. METHODS: Serum lipid profiles and survival data were collected prior to the initiation of chemotherapy combined with immunotherapy. Survival analysis was performed to identify prognostic factors associated with ICC. Independent prognostic factors were used to construct a nomogram. The predictive performance of the nomogram was evaluated. External validation of the survival analysis and nomogram for serum lipids was conducted using a validation cohort. RESULTS: Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and apolipoprotein A1 were selected for further analysis. Survival analysis demonstrated that patients with low LDL-C, high HDL-C, and high ApoA1 levels exhibited significantly longer OS and PFS. A nomogram incorporating LDL-C and HDL-C was constructed to predict 1-, 2-, and 3-year survival probabilities. The nomogram exhibited favorable predictive performance. DISCUSSION: Pre-treatment serum levels of LDL-C, HDL-C, and ApoA1 exhibited significant prognostic value for advanced ICC. The nomogram constructed based on LDL-C and HDL-C effectively predicted survival outcomes, providing a theoretical basis to support treatment decision-making and individualized prognostic assessment in clinical practice.