Nomograms to predict long-term survival for patients with gallbladder
carcinoma after resection
Abstract
Background: 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. Methods: 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. Results: 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. Conclusions: The two nomograms showed an optimally
prognostic prediction in GBC patients after curative-intent resection.