Establishment of a Gallbladder Cancer-Specific Survival Model to Predict Prognosis in Non-metastatic Gallbladder Cancer Patients After Surgical Resection

Zhang, Woods; Hong, Haijie; Chen, Yanling

doi:10.1007/s10620-018-5103-7

Cited by 50 publications

(45 citation statements)

References 10 publications

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“…A number of factors are associated with outcome in incidental gallbladder cancer. Among the most important is the ability to achieve an R0 resection, whereas both a higher T category and the presence of lymph node metastasis are strong predictors of poor survival. Several attempts at refining prognostication have been entertained, with a Gallbladder Cancer Predictive Risk (GBPR) score developed from a multicentre series of incidental gallbladder cancers.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

112

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Background Gallbladder cancer is rare, but cancers detected incidentally after cholecystectomy are increasing. The aim of this study was to review the available data for current best practice for optimal management of incidental gallbladder cancer. Methods A systematic PubMed search of the English literature to May 2018 was conducted. Results The search identified 12 systematic reviews and meta‐analyses, in addition to several consensus reports, multi‐institutional series and national audits. Some 0·25–0·89 per cent of all cholecystectomy specimens had incidental gallbladder cancer on pathological examination. Most patients were staged with pT2 (about half) or pT1 (about one‐third) cancers. Patients with cancers confined to the mucosa (T1a or less) had 5‐year survival rates of up to 100 per cent after cholecystectomy alone. For cancers invading the muscle layer of the gallbladder wall (T1b or above), reresection is recommended. The type, extent and timing of reresection remain controversial. Observation time may be used for new cross‐sectional imaging with CT and MRI. Perforation at initial surgery had a higher risk of disease dissemination. Gallbladder cancers are PET‐avid, and PET may detect residual disease and thus prevent unnecessary surgery. Routine laparoscopic staging before reresection is not warranted for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port‐site metastases is about 10 per cent. Routine resection of port sites has no effect on survival. Adjuvant chemotherapy is poorly documented and probably underused. Conclusion Management of incidental gallbladder cancer continues to evolve, with more refined suggestions for subgroups at risk and a selective approach to reresection.

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Section: Resultsmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

112

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“…Many patients who are older than 60 years face high rates of comorbidities (14,15). Compared with healthy populations, increased morbidity and mortality, which are related to these comorbidities, coexisting pulmonary disease, heart disease, and liver disease, are observed in patients with GBC (16). Deaths caused by these comorbidities, other than original tumors, increases as age increases (17).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Model to Predict Cancer-Specific Survival for Patients With Gallbladder Carcinoma After Surgery: A Population-Based Analysis

Cai

Zhang

et al. 2019

Front. Oncol.

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Predicting the prognosis of gallbladder carcinoma (GBC) has always been important for improving survival. The objective of this study was to determine the risk factors of survival for patients with GBC after surgery and to develop predictive nomograms for overall survival (OS) and cancer-specific survival (CSS) using a large population-based cohort. We identified 2,762 patients with primary resectable GBC in the Surveillance, Epidemiology, and End Results (SEER) database for the period of 2004 to 2014 and another 152 patients with GBC after surgery from Sun Yat-sen University Cancer Center (SYSUCC) for the period of 1997 to 2017. The 1-, 2-, and 3-year cancer-specific mortalities were 37.2, 52.9, and 59.9%, while the competing mortalities were 5.8, 7.8, and 9.0%, respectively. Nomograms were developed to estimate OS and CSS, and these were validated by concordance indexes (C-indexes) and evaluated using receiver operating characteristic (ROC) curves. The C-indexes of the nomograms for OS and CSS prediction were 0.704 and 0.732, respectively. In addition, compared with the 8th Tumor-Node-Metastasis staging system, the newly established nomograms displayed higher areas under the ROC curves for OS and PFS prediction. The nomograms are well-validated and could thus aid individual clinical practice.

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“…The wideaccepted standard Tumor-Node-Metastasis (TNM) staging system of the American Joint Commission on Cancer (AJCC) mainly relies on pathological evaluation of tumor in ltration into the layers of gallbladder, which can only be achieved through surgical excision of the gallbladder and didn't take tumor size into account 6 . The recent studies, which proposed prognostic nomograms/systems, pointed out that patient and tumor-related factors are closely associated with prognosis of GBC patients 7,8 . Notably, several studies have found that tumor size, as an easily quanti able indicator in imaging diagnosis and preoperative assessment, can affect the survival outcome of GBC patients [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…The recent studies, which proposed prognostic nomograms/systems, pointed out that patient and tumor-related factors are closely associated with prognosis of GBC patients 7,8 . Notably, several studies have found that tumor size, as an easily quanti able indicator in imaging diagnosis and preoperative assessment, can affect the survival outcome of GBC patients [7][8][9] . However, the optimal cutoff value of tumor size for predicting prognosis of GBC is still controversial.…”

Section: Introductionmentioning

confidence: 99%

“…However, the optimal cutoff value of tumor size for predicting prognosis of GBC is still controversial. Yadav staging system set tumor size larger than 5 cm as a factor indicated survival disadvantage, whereas Zhang labeled 3 cm as an important prognostic factor 7,8 . In addition, no further studies were conducted to identify the association between the tumor size and other tumor-related factors, such as tumor grade and liver metastasis.…”

Section: Introductionmentioning

confidence: 99%

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Development and external validation of a nomogram for predicting the effect of tumor size on cancer specific survival of resected gallbladder cancer: a population-based study.

Zhang

Han

Wang

et al. 2020

Preprint

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Background & Aims: The impact of tumor size on account of the long-term survival results in gallbladder cancer (GBC) patients has been controversial. It is urgent necessary to identify the optimal cutoff value of tumor size in resected GBC, and we attempted to integrate tumor size with other prognostic factors into a prognostic nomogram to predict the cancer-specific survival (CSS) of GBC patients. Methods 1639 patients with resected GBC were extracted from the Surveillance, Epidemiology and End Results (SEER) database. X-tile program was used to identify the optimal cutoff value of tumor size. A nomogram including tumor size was established to predict 1-, 3- and 5-year CSS based on the independent risk factors chosen by univariate and multivariable cox analyses. The precision of the nomogram for predicting survival was validated with Harrell’s concordance index (C-index), calibration curves, and receiver operating characteristic curve (ROC) internally and externally. Results Patients with GBC were classified into 1–13 mm, 14–63 mm and 64 mm subgroup based on the optimal cutoff for tumor size in terms of CSS. The nomogram according to the independent factors was well calibrated and displayed better discrimination power than 7th Tumor-Node-Metastasis (TNM) stage systems. Conclusions The results demonstrated that increased tumor size is closely associated with the worse CSS. Our novel nomogram, which outperforms the conventional TNM staging system, showed satisfactory accuracy and clinically practicality for predicting the outcome of resected GBC patients.

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Establishment of a Gallbladder Cancer-Specific Survival Model to Predict Prognosis in Non-metastatic Gallbladder Cancer Patients After Surgical Resection

Cited by 50 publications

References 10 publications

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Prognostic Model to Predict Cancer-Specific Survival for Patients With Gallbladder Carcinoma After Surgery: A Population-Based Analysis

Development and external validation of a nomogram for predicting the effect of tumor size on cancer specific survival of resected gallbladder cancer: a population-based study.

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