Gallbladder Cancer With Jaundice: Surgery Versus No Surgery

Sugumaran, K; Jajal, Vasistha M; Nekarakanti, Phani Kumar; Choudhary, Devendra Kumar; Nag, Hirdaya Hulas

doi:10.7759/cureus.30594

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…In our study population for model development, the median postoperative survival was 25 months, with no signi cant difference between the PU and BJ institutions. The survival pro les were consistent with those of previous reports 6, 29 . Additionally, we retrieved and analyzed case listing data from the SEER database (8 registries, 1975-2020), including 1701 GBC cases that received surgical resection 30 .…”

Section: Discussionsupporting

confidence: 91%

Novel Multi-factor Predictive Model for Postoperative Survival in Gallbladder Cancer: A Multi-Center Study

Deng,

Xing,

et al. 2024

Preprint

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Background and study purpose: Gallbladder cancer (GBC) is a highly aggressive malignancy, and surgery is the primary curative option. However, postoperative survival of patients with GBC remains limited. This study aimed to develop a practical model for predicting the postoperative overall survival (OS) of patients with GBC. The model aims to guide surgical decisions and benefit-risk assessments, addressing an unmet need in current practice. Methods A total of 287 patients from three medical institutions were analyzed. Univariate Cox regression analysis was used to screen for prognostic factors. Bidirectional stepwise multivariate Cox regression analysis was used for the feature selection. A nomogram was constructed to predict 1-, 3-, and 5-year postoperative survival rates. The predictive performance of the nomogram was assessed using Harrell's concordance index (C-index), receiver operating characteristic (ROC) curves, and calibration curves. Kaplan-Meier curves and log-rank tests were used to compare survival between the high-risk and low-risk groups determined by the nomogram. Decision curves were used to evaluate the clinical benefits of the nomograms. After training in one institution, internal and external validation were performed in the other two institutions to assess the reliability of the nomogram. Results Eight factors were selected via stepwise regression: TNM stage, serum carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), R0 resection, body mass index (BMI), serum albumin, age-adjusted Charlson Comorbidity Index (aCCI), and serum platelet count. The C-index values were 0.770 and 0.757 before and after bootstrap resampling, respectively. The time-dependent C-index consistently exceeded 0.70 from 6 months to 5 years postoperatively, significantly outperforming TNM staging and CA199 levels. Time-dependent ROC analysis showed an area under the curve (AUC) of over 75% when predicting 1-, 3-, and 5-year postoperative survival. The calibration curves demonstrated good concordance between the predicted and observed 1-, 3-, and 5-year postoperative survival rates. The high-risk group identified by the nomogram exhibited significantly better survival than the low-risk group in both the overall population and in late-stage patients. Decision curves indicated the superior clinical benefits of the novel model compared to TNM staging and CA199 levels. The model performance in the validation process was comparable to that in the training process, demonstrating good reliability. Conclusions Our innovative multi-factor nomogram exhibits excellent discriminative and predictive efficacy, along with robust generalizability. The nomogram model has the potential to be a high-quality tool for forecasting postoperative survival in GBC, aiding clinical decision-making.

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Section: Discussionsupporting

confidence: 91%

Novel Multi-factor Predictive Model for Postoperative Survival in Gallbladder Cancer: A Multi-Center Study

Deng,

Xing,

et al. 2024

Preprint

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“…A positive CDM, direct infiltration of the hepatoduodenal ligament, and densely adherent peri-choledochal LNs were the indicators of EHBD resection. K et al [ 175 ] studied 59 GBC patients who had jaundice. Total of 61.7% and 84%, respectively, of patients underwent CR and non-CR had common bile duct involvement ( P = 0.062).…”

Section: Studies On Surgical Approach and Resectionmentioning

confidence: 99%

Gallbladder cancer: Progress in the Indian subcontinent

Kumar,

Sarangi,

Gupta

et al. 2024

World J Clin Oncol

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Gallbladder cancer (GBC) is one of the commonest biliary malignancies seen in India, Argentina, and Japan. The disease has dismal outcome as it is detected quite late due to nonspecific symptoms and signs. Early detection is the only way to improve the outcome. There have been several advances in basic as well as clinical research in the hepatobiliary and pancreatic diseases in the West and other developed countries but not enough has been done in GBC. Therefore, it is important and the responsibility of the countries with high burden of GBC to find solutions to the many unanswered questions like etiopathogenesis, early diagnosis, treatment, and prognostication. As India being one of the largest hubs for GBC in the world, it is important to know how the country has progressed on GBC. In this review, we will discuss the outcome of the publications from India highlighting the work and the developments taken place in past several decades both in basic and clinical research.

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Novel multifactor predictive model for postoperative survival in gallbladder cancer: a multi-center study

Deng,

Xing,

et al. 2024

World J Surg Onc

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Background Gallbladder cancer (GBC) is a highly aggressive malignancy, with limited survival profiles after curative surgeries. This study aimed to develop a practical model for predicting the postoperative overall survival (OS) in GBC patients. Methods Patients from three hospitals were included. Two centers ( N = 102 and 100) were adopted for model development and internal validation, and the third center ( N = 85) was used for external testing. Univariate and stepwise multivariate Cox regression were used for feature selection. A nomogram for 1-, 3-, and 5-year postoperative survival rates was constructed accordingly. Performance assessment included Harrell's concordance index (C-index), receiver operating characteristic (ROC) curves and calibration curves. Kaplan-Meier curves were utilized to evaluate the risk stratification results of the nomogram. Decision curves were used to reflect the net benefit. Results Eight factors, TNM stage, age-adjusted Charlson Comorbidity Index (aCCI), body mass index (BMI), R0 resection, blood platelet count, and serum levels of albumin, CA125, CA199 were incorporated in the nomogram. The time-dependent C-index consistently exceeded 0.70 from 6 months to 5 years, and time-dependent ROC revealed an area under the curve (AUC) of over 75% for 1-, 3-, and 5-year survival. The calibration curves, Kaplan-Meier curves and decision curves also indicated good prognostic performance and clinical benefit, surpassing traditional indicators TNM staging and CA199 levels. The reliability of results was further proved in the independent external testing set. Conclusions The novel nomogram exhibited good prognostic efficacy and robust generalizability in GBC patients, which might be a promising tool for aiding clinical decision-making. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-024-03533-z.

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Gallbladder Cancer With Jaundice: Surgery Versus No Surgery

Cited by 3 publications

References 20 publications

Novel Multi-factor Predictive Model for Postoperative Survival in Gallbladder Cancer: A Multi-Center Study

Novel Multi-factor Predictive Model for Postoperative Survival in Gallbladder Cancer: A Multi-Center Study

Gallbladder cancer: Progress in the Indian subcontinent

Novel multifactor predictive model for postoperative survival in gallbladder cancer: a multi-center study

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