A Novel Prognostic Nomogram for Gallbladder Cancer after Surgical Resection: A Single-Center Experience.
Journal
Journal of oncology
ISSN: 1687-8450
Titre abrégé: J Oncol
Pays: Egypt
ID NLM: 101496537
Informations de publication
Date de publication:
2021
2021
Historique:
received:
07
12
2020
revised:
16
01
2021
accepted:
23
01
2021
entrez:
27
8
2021
pubmed:
28
8
2021
medline:
28
8
2021
Statut:
epublish
Résumé
Gallbladder cancer (GBC), which accounts for more than 80% of biliary tract malignancies, has a poor prognosis with an overall 5-year survival less than 10%. The study aimed to identify risk factors and develop a predictive model for GBC following surgical resection. 98 GBC patients who underwent surgical resection from Guangdong Provincial People's Hospital were enrolled in the study. Cox-regression analysis was performed to identify significant prognostic factors. A nomogram was constructed and Harrell's concordance index, calibration plot, and decision cure analysis were used to evaluate the discrimination and calibration of the nomogram. Liver resection, tumor size, perineural invasion, surgical margin, and liver invasion were identified as independent risk factors for overall survival (OS) in GBC patients who underwent surgical resection. Based on the selected risk factors, a novel nomogram was constructed. The C-index of the nomogram was 0.777, which was higher than the American Joint Committee on Cancer (AJCC) staging system (0.724) and Nevin staging system (0.659). Decision cure analysis revealed that the nomogram had a better net benefit and the calibration curves for the 1-, 3-, and 5-year survival probabilities were also well matched with the actual survival rates. Lastly, high-risk GBC were stratified based on the scores of the nomogram and we found high-risk GBC were associated with both worse OS and disease-free survival (DFS). We developed a nomogram showing a better predictive capacity for patients' survival of resected GBC than the AJCC staging systems. The established model may help to stratify high-risk GBC and facilitate decision-making in the clinic.
Sections du résumé
BACKGROUND
BACKGROUND
Gallbladder cancer (GBC), which accounts for more than 80% of biliary tract malignancies, has a poor prognosis with an overall 5-year survival less than 10%. The study aimed to identify risk factors and develop a predictive model for GBC following surgical resection.
METHODS
METHODS
98 GBC patients who underwent surgical resection from Guangdong Provincial People's Hospital were enrolled in the study. Cox-regression analysis was performed to identify significant prognostic factors. A nomogram was constructed and Harrell's concordance index, calibration plot, and decision cure analysis were used to evaluate the discrimination and calibration of the nomogram.
RESULTS
RESULTS
Liver resection, tumor size, perineural invasion, surgical margin, and liver invasion were identified as independent risk factors for overall survival (OS) in GBC patients who underwent surgical resection. Based on the selected risk factors, a novel nomogram was constructed. The C-index of the nomogram was 0.777, which was higher than the American Joint Committee on Cancer (AJCC) staging system (0.724) and Nevin staging system (0.659). Decision cure analysis revealed that the nomogram had a better net benefit and the calibration curves for the 1-, 3-, and 5-year survival probabilities were also well matched with the actual survival rates. Lastly, high-risk GBC were stratified based on the scores of the nomogram and we found high-risk GBC were associated with both worse OS and disease-free survival (DFS).
CONCLUSION
CONCLUSIONS
We developed a nomogram showing a better predictive capacity for patients' survival of resected GBC than the AJCC staging systems. The established model may help to stratify high-risk GBC and facilitate decision-making in the clinic.
Identifiants
pubmed: 34447433
doi: 10.1155/2021/6619149
pmc: PMC8383717
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6619149Informations de copyright
Copyright © 2021 Zuyi Ma et al.
Déclaration de conflit d'intérêts
The authors declare that they have no potential conflicts of interest.
Références
Eur J Surg Oncol. 2013 Jun;39(6):548-53
pubmed: 23522952
Surg Oncol Clin N Am. 2009 Apr;18(2):307-24, ix
pubmed: 19306814
J Clin Oncol. 2011 Dec 10;29(35):4627-32
pubmed: 22067404
HPB (Oxford). 2015 Aug;17(8):681-90
pubmed: 26172135
HPB (Oxford). 2017 Nov;19(11):951-956
pubmed: 28750922
Br J Surg. 2020 Sep;107(10):1334-1343
pubmed: 32452559
Cancer. 1976 Jan;37(1):141-8
pubmed: 1247951
J Hepatobiliary Pancreat Surg. 2009;16(2):204-15
pubmed: 19219399
HPB (Oxford). 2016 Nov;18(11):872-878
pubmed: 27527802
Eur J Surg Oncol. 2019 Jun;45(6):1061-1068
pubmed: 30704808
CA Cancer J Clin. 2017 Mar;67(2):93-99
pubmed: 28094848
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
Br J Surg. 2017 Feb;104(3):267-277
pubmed: 28052308
Hepatobiliary Surg Nutr. 2014 Oct;3(5):221-6
pubmed: 25392833
J Cancer. 2019 Jun 2;10(14):3246-3252
pubmed: 31289596
Eur J Surg Oncol. 2020 Nov;46(11):2106-2113
pubmed: 32807616
J Hepatobiliary Pancreat Sci. 2014 Jul;21(7):453-8
pubmed: 24591403
Gut Liver. 2019 Jan 15;13(1):104-113
pubmed: 29938462
World J Surg Oncol. 2019 Nov 30;17(1):200
pubmed: 31785615
Cancers (Basel). 2020 Jul 27;12(8):
pubmed: 32726993
J Hepatobiliary Pancreat Sci. 2013 Jun;20(5):518-24
pubmed: 23430053
Ann Surg Oncol. 2015 Aug;22(8):2779-86
pubmed: 25519930
J Neurol Surg B Skull Base. 2016 Apr;77(2):96-106
pubmed: 27123385