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The coronavirus disease 2019 (COVID-19) outbreak has brought numerous challenges to the public health system since December 2019. Chinese government, hospitals, and doctors have made tremendous efforts to restrain the pandemic. All patients with fever or pneumonia of undetermined origin or suspected COVID-19 infection are being transferred to COVID-19-designated hospitals for diagnosis and quarantine. To confront the massive demand of human and medical resources, a large number of medical professionals from various specialties have been voluntarily grouped together to support the front line against COVID-19, 1 and medical supplies are centralized in relevant departments. All these strict measures were taken as earlier as possible and had showed effectiveness in controlling the rapid spread of COVID-19. As the number of new infections has been declining since February, we have achieved tremendous success in containing COVID-19 infection and transmission in China and our experience of battling against this epidemic is valuable for the rest of the world. 2 At the same time, the outbreak exerted tremendous impacts on surgical patients in China. Elective surgeries dropped by 70-95% in Chinese hospitals during the epidemic (Figure 1A). 3 The shortage of medical resources such as personal protective equipment and blood, and the strict administrative policy for preventing infection are the main reasons. In addition, due to the possible person-toperson infection in hospitals, surgical patients refrained from coming to hospital to seek medical care. However, certain surgical patients, such as acute abdomen, digestive tumors, cholelithiasis, gastrointestinal bleeding, and abdominal injury, are likely to face worse outcomes without timely surgery. Therefore, another issue arose as how to provide safe and high-quality surgical care to patients during the COVID-19 outbreak. In this regard, Chinese hospitals have taken following measures based the protocols from the National Health Commission of China and experience learned from the fight against SARS. 4 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

e16140 Background: Gallbladder neuroendocrine neoplasm (GB-NEN) is an extremely rare type of gallbladder neoplasm and the prognosis of patients with GB-NENs varies widely. The focus of this study was to construct and validate a prognostic model of GB-NENs based on the data from a nationwide retrospective multicenter registry cohort. Methods: The Chinese Research Group of Gallbladder Cancer (CRGGC) study is a multicenter retrospective registry cohort study reviewing the electronic medical records from 76 tertiary and secondary hospitals across 28 provinces in China. We assembled patients with GB-NEN diagnosed between 2010 and 2017 in 24 tertiary hospitals from CRGGC study. Influential factors of recurrence free survival (RFS) and overall survival (OS) were identified using Least absolute shrinkage and selection operator (LASSO) regression and Cox predicting model was constructed for predicting RFS and OS. The prognostic model was validated both internally and externally. Performance of the model was assessed by concordance index (C-index) and calibration curves stratified by risk categories. Results: A total of 84 patients with GB-NEN was extracted from CRGGC study, among which 3 were diagnosed with GB-NEN Grade 1, 8 were diagnosed with GB-NEN Grade 2 and 35 with GB-NEN Grade 3. Of the 35 patients with GB-NEN Grade 3, 3 had poorly differentiated small-cell neuroendocrine carcinomas (SC-NECs) and 8 patients had Mixed neuroendocrine–non‐neuroendocrine neoplasms (MiNENs). 53 patients were included in the training group (median survival, 21.1 months; 95% confidence interval (CI), 13.8-37.6 months) and 31 patients in the validation cohort (median survival, 34.3 months; 95% CI, 9.63-58.97months). A Cox predicting model was built, including 5 variables (age, TNM stage, surgery, metastasis at liver, proportion of positive lymph nodes examined). The C-index was 78.1 (95% CI, 63.9-92.3), with a good calibration, and these results were confirmed in the internal validation cohorts. Conclusions: We have built a clinical model for GB-NEN patients and clinical doctors for prognosis prediction based on age, TNM stage, surgery, metastasis at liver, proportion of positive lymph nodes examined which can be easily obtained in one’s case history. It can be used to determine subgroups of patients who may have poorer prognosis and assist individualized and precise treatment for GB-NEN.