Development and External Validation of a Model to Predict Overall Survival in Patients With Resected Gallbladder Cancer

Abstract

Objective: The aim of this study was to develop and validate a clinical prediction model to predict overall survival in patients with nonmetastatic, resected gallbladder cancer (GBC). Background: Although several tools are available, no optimal method has been identified to assess survival in patients with resected GBC. Methods: Data from a Dutch, nation-wide cohort of patients with resected GBC was used to develop a prediction model for overall survival. The model was internally validated and a cohort of Australian GBC patients who underwent resection was used for external validation. The performance of the American Joint Committee on Cancer (AJCC) staging system and the present model were compared. Results: In total, 446 patients were included; 380 patients in the development cohort and 66 patients in the validation cohort. In the development cohort median survival was 22 months (median follow-up 75 months). Age, T/N classification, resection margin, differentiation grade, and vascular invasion were independent predictors of survival. The externally validated C-index was 0.75 (95%CI: 0.69–0.80), implying good discriminatory capacity. The discriminative ability of the present model after internal validation was superior to the ability of the AJCC staging system (Harrell C-index 0.71, [95%CI: 0.69–0.72) vs. 0.59 (95% CI: 0.57–0.60)]. Conclusion: The proposed model for the prediction of overall survival in patients with resected GBC demonstrates good discriminatory capacity, reasonable calibration and outperforms the authoritative AJCC staging system. This model can be a useful tool for physicians and patients to obtain information about survival after resection and is available from https:// gallbladderresearch.shinyapps.io/Predict_GBC_survival/.

A Novel Clinically Prognostic Stratification Based on Prognostic Nutritional Index Status and Histological Grade in Patients With Gallbladder Cancer After Radical Surgery

“…An early prediction of poor prognosis can effectively benefit preoperative or intraoperative individualized surgical plans, which have been verified by some experienced scholars ( 34 – 36 ). Ethun et al analyzed 262 cases of accidental GBC from multiple centers and added the parameters, such as T stage, degree of differentiation, vascular invasion, and perineural invasion to establish the prediction model of local residual lesions, distant metastasis, and long-term survival ( 37 ).…”

Long-term prognosis of patients with gallbladder carcinoma after curative-intent resection based on changes in the ratio of carbohydrate antigen 19-9 to total bilirubin (CA19-9/TB): a multicenter retrospective cohort study

“…With advances in surgical technologies, surgical resection has become the preferred treatment for resectable GBC 20 . However, the highly malignant nature of GBC has led to suboptimal long-term survival outcomes even after radical resection, with a median OS of approximately 22 months 21 . There is an urgent clinical need in predicting postoperative survival in GBC patients to guide clinicians to select patients for surgery and to choose whether or not to administer adjuvant chemotherapy for these patients.…”

Development and external validation of a prognosis model to predict outcomes after curative resection of early-stage intrahepatic cholangiocarcinoma

“…Emerging evidence now indicates that clinicopathologic features have the potential to reflect tumor growth and invasion ability, and have increasingly been integrated into prognosis evaluation to identify actionable prognostic factors as early as possible (15)(16)(17). To our knowledge, no studies have so far used clinicopathologic features to develop predictive prognosis models in patients with ESICC for risk stratification and guiding cancer care.…”