Development and Validation of a Nomogram for Predicting Survival in Gallbladder Cancer Patients With Recurrence After Surgery

Frontiers in Oncology

Xiaozhong Lv¹  Jian Lin²  Jiahao Hu³  Shijie Li³  Jiliang Shen³  Jiasheng Cao³  Mingyu Chen⁴  Win Topatana⁵  Sarun Juengpanich⁵  Xiujun Cai⁵ 

[1] Department of General Surgery, First People’s Hospital, Mudanjiang, China;Department of General Surgery, Longyou People’s Hospital, Quzhou, China;Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China;Engineering Research Center of Cognitive Healthcare of Zhejiang Province, Hangzhou, China;Zhejiang University School of Medicine, Hangzhou, China;

关键词: gallbladder cancer;    recurrence;    survival;    nomogram;    prognostic model;   

DOI  :  10.3389/fonc.2020.537789

来源: DOAJ

【 摘 要 】

BackgroundThe management of gallbladder cancer (GBC) patients with recurrence who need additional therapy or intensive follow-up remains controversial. Therefore, we aim to develop a nomogram to predict survival in GBC patients with recurrence after surgery.MethodsA total of 313 GBC patients with recurrence from our center was identified as a primary cohort, which were randomly divided into a training cohort (N = 209) and an internal validation cohort (N = 104). In addition, 105 patients from other centers were selected as an external validation cohort. Independent prognostic factors, identified by univariate and multivariable analysis, were used to construct a nomogram. The performance of this nomogram was measured using Harrell’s concordance index (C-index) and calibration curves.ResultsOur nomogram was established by four factors, including time-to-recurrence, site of recurrence, CA19-9 at recurrence, and treatment of recurrence. The C-index of this nomogram in the training, internal and external validation cohort was 0.871, 0.812, and 0.754, respectively. The calibration curves showed an optimal agreement between nomogram prediction and actual observation. Notably, this nomogram could accurately stratify patients into different risk subgroups, which allowed more significant distinction of Kaplan-Meier curves than that of using T category. The 3-year post-recurrence survival (PRS) rates in the low-, medium-, and high-risk subgroups from the external validation cohort were 53.3, 26.2, and 4.1%, respectively.ConclusionThis nomogram provides a tool to predict 1- and 3-year PRS rates in GBC patients with recurrence after surgery.

【 授权许可】

Unknown