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基于术前 MRI 的列线图预测胆囊癌根治性切除术后患者的生存:一项回顾性多中心分析。

Preoperative MRI-based nomogram to predict survival after curative resection in patients with gallbladder cancer: a retrospective multicenter analysis.

机构信息

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-Ro, Gangnam-gu, Seoul, 06351, Korea.

Department of Radiology and Research Institute of Radiological Science, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul, 110-744, Republic of Korea.

出版信息

Abdom Radiol (NY). 2024 Nov;49(11):3847-3861. doi: 10.1007/s00261-024-04444-z. Epub 2024 Jul 5.

Abstract

PURPOSE

To use preoperative MRI data to construct a nomogram to predict survival in patients who have undergone R0 resection for gallbladder cancer.

METHODS

The present retrospective study included 143 patients (M:F, 76:67; 67.15 years) with gallbladder cancer who underwent preoperative MRI and subsequent R0 resection between 2013 and 2021 at two tertiary institutions. Clinical and radiological features were analyzed using univariate and multivariate Cox regression analysis to identify independent prognostic factors. Based on the multivariate analysis, we developed an MRI-based nomogram for determining prognoses after curative resections of gallbladder cancer. We also obtained calibration curves for 1-,3-, and 5-year survival probabilities.

RESULTS

The multivariate model consisted of the following independent predictors of poor overall survival (OS), which were used for constructing the nomogram: age (years; hazard ratio [HR] = 1.04; 95% confidence interval [CI], 1.04-1.07; p = 0.033); tumor size (cm; HR = 1.40; 95% CI, 1.09-1.79; p = 0.008); bile duct invasion (HR = 3.54; 95% CI, 1.66-7.58; p = 0.001); regional lymph node metastasis (HR = 2.47; 95% CI, 1.10-5.57; p = 0.029); and hepatic artery invasion (HR = 2.66; 95% CI, 1.04-6.83; p = 0.042). The nomogram showed good probabilities of survival on the calibration curves, and the concordance index of the model for predicting overall survival (OS) was 0.779.

CONCLUSION

Preoperative MRI findings could be used to determine the prognosis of gallbladder cancer, and the MRI-based nomogram accurately predicted OS in patients with gallbladder cancer who underwent curative resection.

摘要

目的

利用术前 MRI 数据构建列线图,以预测行 R0 切除术的胆囊癌患者的生存情况。

方法

本回顾性研究纳入了 2013 年至 2021 年在两家三级医疗机构接受术前 MRI 检查和随后 R0 切除术的 143 名胆囊癌患者(男:女,76:67;67.15 岁)。使用单变量和多变量 Cox 回归分析对临床和影像学特征进行分析,以确定独立的预后因素。基于多变量分析,我们为胆囊癌根治性切除术后的预后制定了一个基于 MRI 的列线图。我们还获得了 1 年、3 年和 5 年生存率的校准曲线。

结果

多变量模型中,与总生存(OS)不良相关的独立预测因素包括:年龄(岁;风险比[HR] = 1.04;95%置信区间[CI],1.04-1.07;p = 0.033);肿瘤大小(cm;HR = 1.40;95% CI,1.09-1.79;p = 0.008);胆管侵犯(HR = 3.54;95% CI,1.66-7.58;p = 0.001);区域淋巴结转移(HR = 2.47;95% CI,1.10-5.57;p = 0.029);和肝动脉侵犯(HR = 2.66;95% CI,1.04-6.83;p = 0.042)。列线图在校准曲线上显示出良好的生存概率,该模型预测总生存(OS)的一致性指数为 0.779。

结论

术前 MRI 结果可用于确定胆囊癌的预后,基于 MRI 的列线图可准确预测行根治性切除术的胆囊癌患者的 OS。

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