现有的预后模型对于肝内胆管癌（ICC）的价值有限。包含预后基因突变将增强预测效果。在筛选队列中，采用单变量Cox回归分析，研究个体突变基因对总生存期（OS）的影响。在训练集中，进行多变量分析，评估临床病理和突变参数的独立预后作用，并构建预后模型。进行内部和外部验证，评估该模型的性能。在复发性突变中，只有TP53和KRASG12与三个筛选队列的OS显著关联。在训练队列中，TP53和KRASG12突变结合其他七个临床参数（肿瘤大小、肿瘤数量、血管侵犯、淋巴结转移、邻近侵犯、CA19-9和CEA），独立预后因素，用于OS预测。建立基于这九个预测因子的突变注释预后评分（MAPS）。MAPS的C指数（内部验证队列为0.782，外部验证队列为0.731）显著高于其他现有模型（P<0.05）。此外，MAPS模型还具有预测直接手术和辅助治疗可能益处的显著价值。MAPS模型在预测ICC患者的OS方面表现良好，并可用于预测直接手术和辅助治疗的可能益处。版权所有 © 2023作者。由Wolters Kluwer Health, Inc.出版。

The value of existing prognostic models for intrahepatic cholangiocarcinoma (ICC) is limited. The inclusion of prognostic gene mutations would enhance the predictive efficacy.In the screening cohorts, univariable Cox regression analysis was applied to investigate the effect of individual mutant genes on overall survival (OS). In the training set, multivariable analysis was performed to evaluate the independent prognostic roles of the clinicopathological and mutational parameters, and a prognostic model was constructed. Internal and external validations were conducted to evaluate the performance of this model.Among the recurrent mutations, only TP53 and KRASG12 were significantly associated with OS across all three screening cohorts. In the training cohort, TP53 and KRASG12 mutations in combination with seven other clinical parameters (tumor size, tumor number, vascular invasion, lymph node metastasis, adjacent invasion, CA19-9, and CEA), were independent prognostic factors for OS. A mutation-annotated prognostic score (MAPS) was established based on the nine prognosticators. The C-indices of MAPS (0.782 and 0.731 in the internal and external validation cohorts, respectively) were statistically higher than those of other existing models (P<0.05). Furthermore, the MAPS model also demonstrated significant value in predicting the possible benefits of upfront surgery and adjuvant therapy.The MAPS model demonstrated good performance in predicting OS of ICC patients. It may also help predict the possible benefits of upfront surgery and adjuvant therapy.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.