Tsilimigras DI, Mehta R, Aldrighetti L, et al. - A composite score incorporating preoperative liver, tumor, nutritional, and inflammatory markers was developed for the prediction of long-term outcomes after resection of intrahepatic cholangiocarcinoma. Using an international multi-institutional database, researchers assessed data from 660 patients; among these patients median OS was 43.2 months and the 5-year OS rate was 42.4%. On multivariable analysis, carbohydrate antigen 19-9, neutrophil-to-lymphocyte ratio, platelet count, and albumin were associated with OS. They developed a weighted LabScore based on the formula: (8.2 + 1.45 × natural logarithm of carbohydrate antigen 19-9 + 0.84 × neutrophil-to-lymphocyte ratio + 0.03 × platelets – 2.83 × albumin). They observed incrementally worse 5-year OS rates of 54.9%, 38.2% and 21.6% for patients with a LabScore of 0 to 9 (n = 223), 10 to 19 (n = 353) and ≥ 20 (n = 88), respectively. In both the test (c-index 0.70) and validation cohorts, the model performed well (c-index 0.67) and further, it outperformed individual laboratory markers, the prognostic nutritional index (c-index 0.58), and American Joint Committee on Cancer staging system (c-index 0.60).