Department of Hepatic Surgery II, The Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Department of Biliary Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Cancer Rep (Hoboken). 2024 Mar;7(3):e1991. doi: 10.1002/cnr2.1991.
Surgical resection remains the primary treatment option for gallbladder carcinoma (GBC). However, there is a pressing demand for prognostic tools that can refine patients' treatment choices and tailor personalized therapies accordingly.
The nomograms were constructed using the data of a training cohort (n = 378) of GBC patients at Eastern Hepatobiliary Surgery Hospital (EHBH) between 2008 and 2018. The model's performance was validated in GBC patients (n = 108) at Guangzhou Centre from 2007 to 2018.
The 5-year overall survival (OS) rate in the training cohort was 24.4%. Multivariate analyses were performed using preoperative and postoperative data to identify independent predictors of OS. These predictors were then incorporated into preoperative and postoperative nomograms, respectively. The C-index of the preoperative nomogram was 0.661 (95% CI, 0.627 to 0.694) for OS prediction and correctly delineated four subgroups (5-year OS rates: 48.1%, 19.0%, 15.6%, and 8.1%, p < 0.001). The C-index of the postoperative nomogram was 0.778 (95%CI, 0.756 -0.800). Furthermore, this nomogram was superior to the 8th TNM system in both C-index and the net benefit on decision curve analysis. The results were externally validated.
The two nomograms showed an optimally prognostic prediction in GBC patients after curative-intent resection.
手术切除仍然是胆囊癌（GBC）的主要治疗选择。然而，迫切需要能够完善患者治疗选择并相应制定个性化治疗方案的预后工具。
使用东方肝胆外科医院（EHBH） 2008 年至 2018 年期间 378 例 GBC 患者的数据构建列线图。该模型在 2007 年至 2018 年期间广州中心的 108 例 GBC 患者中进行了验证。
训练队列的 5 年总生存率（OS）为 24.4%。使用术前和术后数据进行多变量分析，以确定 OS 的独立预测因素。然后将这些预测因素分别纳入术前和术后列线图中。术前列线图的 C 指数为 0.661（95%CI，0.627-0.694），用于预测 OS，并正确划定了四个亚组（5 年 OS 率：48.1%、19.0%、15.6%和 8.1%，p<0.001）。术后列线图的 C 指数为 0.778（95%CI，0.756-0.800）。此外，该列线图在 C 指数和决策曲线分析中的净效益方面均优于第 8 版 TNM 系统。结果得到了外部验证。
这两个列线图在根治性切除术后的 GBC 患者中表现出了最佳的预后预测能力。
