Fang Cheng, Li Wenhui, Wang Qingqiang, Wang Ruoran, Dong Hui, Chen Junjie, Chen Yong
Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Department of Gynecology and Obstetrics, Changhai Hospital, Second Military Medical University, Shanghai, China.
Front Surg. 2022 Aug 23;9:899896. doi: 10.3389/fsurg.2022.899896. eCollection 2022.
Liver metastasis is a common complication in gallbladder cancer (GBC). We design this study to develop models for predicting the development of liver metastasis in GBC patients and evaluate the risk of mortality in these patients with liver metastasis.
GBC patients from Surveillance Epidemiology and End Results (SEER) between 2010 and 2016 were included in this study. Logistic regression was performed to discover risk factors and construct predictive models for liver metastasis in GBC patients. Cox regression was utilized to find risk factors of mortality in GBC patients with liver metastasis. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the performance of the constructed predictive models.
Multivariate logistic regression confirmed that T stage, N stage, and tumor grade were risk factors for liver metastasis in GBC patients. Composed of these factors, the model for predicting the development of liver metastasis had AUCs of 0.707 and 0.657 in the training cohort and testing cohort, respectively. Multivariate Cox regression showed that surgery of the primary site and chemotherapy were independently associated with the mortality of GBC patients with liver metastasis. Composed of these two factors, the predictive model for 1-year mortality of GBC patients with liver metastasis had AUCs of 0.734 and 0.776 in the training cohort and testing cohort, respectively.
The predictive models that we constructed are helpful for surgeons to evaluate the risk of liver metastasis in GBC patients and the survival condition of those with liver metastasis. Surgery of the primary site and chemotherapy should be provided for GBC with liver metastasis.
肝转移是胆囊癌（GBC）常见的并发症。我们开展本研究以建立预测GBC患者肝转移发生的模型，并评估这些发生肝转移患者的死亡风险。
本研究纳入了2010年至2016年监测、流行病学和最终结果（SEER）数据库中的GBC患者。进行逻辑回归以发现危险因素并构建GBC患者肝转移的预测模型。利用Cox回归找出发生肝转移的GBC患者的死亡危险因素。计算受试者工作特征曲线（AUC）下面积以评估所构建预测模型的性能。
多因素逻辑回归证实，T分期、N分期和肿瘤分级是GBC患者肝转移的危险因素。由这些因素组成的预测肝转移发生的模型在训练队列和测试队列中的AUC分别为0.707和0.657。多因素Cox回归显示，原发部位手术和化疗与发生肝转移的GBC患者的死亡率独立相关。由这两个因素组成的发生肝转移的GBC患者1年死亡率预测模型在训练队列和测试队列中的AUC分别为0.734和0.776。
我们构建的预测模型有助于外科医生评估GBC患者肝转移风险以及发生肝转移患者的生存状况。对于发生肝转移的GBC患者应进行原发部位手术和化疗。
