Development and validation of a prognostic nomogram for gallbladder cancer patients after surgery

Xu, Xingwei; He, Min; Wang, Hui; Zhan, Ming; Yang, Linhua

doi:10.1186/s12876-022-02281-2

Cited by 18 publications

(10 citation statements)

References 17 publications

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“…In the Cox regression analysis, we identified that the age, primary site, grade, and radiotherapy were independent prognostic factors for CSS in patients with pancreatic MCAC. Age and grade have been found to be independent factors for cancer prognosis in many studies ( 18 – 20 ). At the primary site, the tumors at the head of pancreas have a better prognosis than those at other sites.…”

Section: Discussionmentioning

confidence: 99%

Cancer-specific survival and metastasis in pancreatic mucinous cystadenocarcinoma: A SEER-based cohort study

Wang

Su²,

Liu³

et al. 2022

Front. Oncol.

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AimsThis study aimed to investigate the prognostic value of clinical features for cancer-specific survival (CSS) and metastasis in patients with pancreatic mucinous cystadenocarcinoma (MCAC). We further constructed and validated an effective nomogram to predict CSS.MethodsWe screened patients diagnosed with pancreatic MCAC from Surveillance Epidemiology and End Results (SEER) database. Kaplan-Meier curves were used to determine the CSS time. Univariate and multivariate Cox and logistic regression analyses were conducted to identify the prognostic factors for CSS and metastasis. The nomogram was constructed to predict the prognosis of pancreatic MCAC based on the results from the multivariate analysis. We used the concordance index (C-index), the area under the curve (AUC), and the calibration plots to determine the predictive accuracy and discriminability of the nomogram.ResultsMultivariate Cox analysis revealed that age, primary site, grade, and radiotherapy were independent prognostic factors associated with CSS. Multivariate logistic regression analysis revealed that surgery and grade were independent risk factors associated with metastasis. The independent risk factors were included to construct a prognosis prediction model for predicting CSS in patients with pancreatic MCAC. The concordance index (C-index), receiver operating characteristic (ROC) curves, and calibration plots of the training cohort and the validation cohort showed that the nomogram had an acceptable predictive performance.ConclusionWe established a nomogram that could determine the 3- and 5-year CSS, which could evaluate individual clinical outcomes and provide individualized clinical decisions.

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Section: Discussionmentioning

confidence: 99%

Cancer-specific survival and metastasis in pancreatic mucinous cystadenocarcinoma: A SEER-based cohort study

Wang

Su²,

Liu³

et al. 2022

Front. Oncol.

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“…Written consent was obtained from all the patients involved in the present study. Each patient's age, sex, differentiation, Nevin stage ( 28 ), tumor invasion, regional lymph node metastasis, distant metastasis and histological stage were obtained.…”

Section: Methodsmentioning

confidence: 99%

HHLA2 promotes tumor progression by long non‑coding RNA H19 in human gallbladder cancer

Zhang

et al. 2022

Int J Oncol

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Advanced gallbladder cancer (GBC) is one of the most malignant of all types of biliary tract cancers that is associated with poor prognosis and high mortality. Accumulating evidence suggest that the B7 family of proteins serve an essential role in various types of cancers, including GBC. However, the potential function and regulatory mechanism of human endogenous retrovirus-H long terminal repeat-associating protein 2 (HHLA2; also known as B7-H7 or B7H5) in GBC remain poorly understood. In the present study, immunohistochemistry was used to examine the expression pattern of HHLA2 in samples from 89 patients with GBC. The possible association between HHLA2 expression and the clinicopathological parameters, including prognosis, were then assessed. Using lentiviruses, overexpression of HHLA2 plasmid or short-hairpin RNA (shRNA) of HHLA2 were transfected into GBC-SD cells to overexpress or knock down HHLA2 expression, respectively. The effects of HHLA2 overexpression and knockdown on the epithelial-mesenchymal transition (EMT) process on GBC-SD cells were measured by the western blotting and immunofluorescence staining of collagen I, N-cadherin, E-cadherin, vimentin and α-SMA. By contrast, changes in cell proliferation were measured using EdU assay. Cell invasion and migration were assessed using Transwell and wound-healing assays, respectively. In addition, a xenograft mouse model was established to evaluate the tumorigenic ability of the GBC cell line in vivo after stable transfection with lentivirus for HHLA2 overexpression or shRNA for HHLA2 knockdown. The regulatory relationships among TGF-β1, long non-coding RNA (lncRNA) H19 (H19) and HHLA2 were then investigated. The mRNA expression of lncRNA H19 were assessed using reverse transcription-quantitative PCR, whereas the expression levels of HHLA2 were detected by western blotting and immunofluorescence staining. HHLA2 expression was found to gradually increase as the stages of the GBC samples become more advanced. In addition, the expression level of HHLA2 was calculated to be positively associated with the Nevin stage, American Joint Committee on Cancer stage, tumor invasion and regional lymph node metastasis but was negatively associated with the overall patient survival (OS). In vitro experiments demonstrated that overexpression of HHLA2 promoted GBC migration, invasion, proliferation and EMT, whereas in vivo experiments found a promoting role of HHLA2 overexpression on GBC tumor growth. After transfection with lentiviruses encoding the overexpression plasmid of lncRNA H19, GBC migration, invasion, proliferation and EMT were increased. By contrast, knocking down HHLA2 expression suppressed TGF-β1- or lncRNA H19 overexpression-induced GBC migration, invasion, proliferation and EMT. In addition, HHLA2 knockdown significantly reduced the sizes of the GBC tumors in vivo . These results suggest that HHLA2 overexpression can promote GBC progression. Conversely, ablation...

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“…Surgery remains a fundamental part of GBC management and is the only potentially curative modality (13). Although many studies have reported some prognostic factors for GBC patients, including age, TNM stage, tumor size, adjuvant therapy, and pathological grade (11,(14)(15)(16)(17), there were little data on the survival benefit of surgery in elderly patients with GBC. This special population was rarely included in randomized controlled trials that exploring the effect of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The benefit of surgery for the old population has been discussed, but the results were contradictory (8-10). Several studies have also shown that age is a risk factor for prognosis in patients undergoing surgery for gallbladder cancer (11,12). Thus, whether elderly patients with gallbladder cancer can benefit from surgical treatment or not is a topic worth exploring.…”

Section: Introductionmentioning

confidence: 99%

Effects of surgery on survival of elderly patients with gallbladder cancer: A propensity score matching analysis of the SEER database

Wang

Duan

2023

Front. Oncol.

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BackgroundSurgery is the sole curative therapy for gallbladder cancer (GBC) patients. Confronting an aging society, the demand to treat elderly patients with GBC is increasing. But there are few reports on survival benefit in elderly GBC patients treated with surgery. Therefore, we designed this population-based study to assess the survival benefit of surgery in GBC patients aged 70 years or older.MethodsGBC patients aged 70 years or older were identified in the surveillance, epidemiology, and end results cancer (SEER) database from 2010 to 2017. A 1:1 propensity score matching (PSM) analysis was conducted to balance the baseline data of patients. Overall survival (OS) and cancer-specific survival (CSS) of patients were evaluated by Kaplan-Meier analysis and compared with log-rank test. Independent risk factors associated with OS and CSS were determined by univariate and multivariate Cox proportional hazard regression analyses and subgroup analysis were performed.ResultsA total of 2055 GBC patients aged 70 years or older were included in our study, with 1734 patients underwent surgery. Before PSM, the age, AJCC stage, TNM stage, and chemotherapy were significantly different between the surgery and no-surgery group (all P<0.05). Patients with surgery had significantly longer OS and CSS than those without surgery (P<0.0001). After 1:1 PSM, the differences in clinicopathological characteristics were reduced (all P>0.05). Kaplan-Meier analysis also showed patients received surgery had significantly better OS and CSS (P<0.0001). Subgroup analysis further indicated that almost all subgroups received surgery had OS and CSS advantage, especially patients aged 70-84 years old. Finally, univariate and multivariate COX regression analyses showed that age, AJCC stage and T stage were independent prognostic factors for OS and CSS in patients undergoing surgery.ConclusionOur study found that surgery significantly improved OS and CSS in GBC patients aged 70-84 years, but more prospective studies are needed to prove our findings.

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Development and validation of a prognostic nomogram for gallbladder cancer patients after surgery

Cited by 18 publications

References 17 publications

Cancer-specific survival and metastasis in pancreatic mucinous cystadenocarcinoma: A SEER-based cohort study

Cancer-specific survival and metastasis in pancreatic mucinous cystadenocarcinoma: A SEER-based cohort study

HHLA2 promotes tumor progression by long non‑coding RNA H19 in human gallbladder cancer

Effects of surgery on survival of elderly patients with gallbladder cancer: A propensity score matching analysis of the SEER database

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