Yang Si-Qi, Zou Rui-Qi, Dai Yu-Shi, Wang Jun-Ke, Ma Wen-Jie, Hu Hai-Jie, Li Fu-Yu
Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Cancer Med. 2025 Sep;14(18):e71203. doi: 10.1002/cam4.71203.
The most suitable prognostic prediction system for gallbladder cancer (GBC) is yet to be determined. This study aims to establish a combined score integrating preoperative patients' nutritional and immune status and pathological parameters to forecast the survival outcomes following curative-intent surgery of GBC.
This retrospective study included patients diagnosed with GBC based on postoperative pathological examinations. The patients underwent curative surgery at West China Hospital of Sichuan University (China) between January 2014 and December 2022. Using the controlling nutritional status (CONUT) score and gallbladder cancer predictive risk score (GBRS), we generated the CONUT-GBRS for every patient, and the patients were divided into two groups based on the optimal cutoff value. Comparisons were made between the two groups regarding clinicopathologic features and survival.
The optimal cutoff value for the CONUT-GBRS was 1.39. There were 99 and 201 individuals in the high and low CONUT-GBRS groups, respectively. Patients with high CONUT-GBRS experienced poorer overall survival and disease-free survival compared with those with low CONUT-GBRS, even after propensity score matching analysis. Both univariate and multivariate Cox analyses established that CONUT-GBRS stood as an independent prognostic factor for GBC patients. Subgroup analysis indicated that CONUT-GBRS was also an effective predictor of prognosis in patients with incidental GBC.
The CONUT-GBRS serves as an advantageous, straightforward, and cost-effective prognostic tool for GBC, offering valuable prognostic insights and guiding the tailoring of individualized treatment strategies to improve patient outcomes.
胆囊癌（GBC）最合适的预后预测系统尚未确定。本研究旨在建立一个综合评分，整合术前患者的营养和免疫状况以及病理参数，以预测GBC根治性手术后的生存结果。
这项回顾性研究纳入了根据术后病理检查确诊为GBC的患者。2014年1月至2022年12月期间，这些患者在四川大学华西医院接受了根治性手术。我们使用控制营养状况（CONUT）评分和胆囊癌预测风险评分（GBRS），为每位患者生成CONUT-GBRS，并根据最佳临界值将患者分为两组。比较两组的临床病理特征和生存率。
CONUT-GBRS的最佳临界值为1.39。CONUT-GBRS高分组和低分组分别有99例和201例患者。即使经过倾向评分匹配分析，CONUT-GBRS高的患者与CONUT-GBRS低的患者相比，总生存期和无病生存期更差。单因素和多因素Cox分析均表明，CONUT-GBRS是GBC患者的独立预后因素。亚组分析表明，CONUT-GBRS也是意外性GBC患者预后的有效预测指标。
CONUT-GBRS是一种对GBC有利、简单且具有成本效益的预后工具，提供有价值的预后见解，并指导制定个体化治疗策略以改善患者预后。
