Development and Validation of a Nomogram for Predicting Survival in Gallbladder Cancer Patients With Recurrence After Surgery.
Development and Validation of a Nomogram for Predicting Survival in Gallbladder Cancer Patients With Recurrence After Surgery.
复制标题
预测胆囊癌术后复发患者生存率的列线图的开发和验证
DOI：
10.3389/fonc.2020.537789
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发表时间：
2020
影响因子：
4.7
通讯作者：
Cai X
中科院分区：
文献类型：
--
作者：
Chen M;Li S;Topatana W;Lv X;Cao J;Hu J;Lin J;Juengpanich S;Shen J;Cai X
背景对于需要额外治疗或强化随访的胆囊癌复发患者的处理仍存在争议。因此，我们的目标是开发一个诺模图来预测GBC患者术后复发的生存率。方法将313例复发性胆囊癌患者随机分为培训组（N = 209）和内部验证组（N = 104）。此外，从其他中心选择105例患者作为外部验证队列。通过单变量和多变量分析确定的独立预后因素被用来构建列线图。使用Harrell一致性指数（C指数）和校准曲线测量该列线图的性能。结果我们建立的诺模图包括复发时间、复发部位、复发时CA 19 -9和复发治疗4个因素。该诺模图在培训、内部和外部验证队列中的C指数分别为0.871、0.812和0.754。标定曲线显示诺模图预测与实际观测之间的最佳协议。值得注意的是，该诺模图可以准确地将患者分为不同的风险亚组，这使得Kaplan-Meier曲线比使用T分类更显著。来自外部验证队列的低、中和高风险亚组的3年复发后生存率（PRS）分别为53.3%、26.2%和4.1%。结论该列线图可用于预测GBC术后复发患者1年和3年的PRS率。
Background The 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. Methods A 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. Results Our 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. Conclusion This nomogram provides a tool to predict 1- and 3-year PRS rates in GBC patients with recurrence after surgery.
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DOI：
10.1007/s00534-007-1279-5
发表时间：
2008
期刊：
JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY
影响因子：
--
作者：
Kondo, Satoshi;Takada, Tadahiro;Miyazaki, Masaru;Miyakawa, Shuichi;Tsukada, Kazuhiro;Nagino, Masato;Furuse, Junji;Saito, Hiroya;Tsuyuguchi, Toshio;Yamamoto, Masakazu;Kayahara, Masato;Kimura, Fumio;Yoshitomi, Hideyuki;Nozawa, Satoshi;Yoshida, Masahiro;Wada, Keita;Hirano, Satoshi;Amano, Hodaka;Miura, Fumihiko
通讯作者：
Miura, Fumihiko
影响因子：
2.9
作者：
Wen, Zhijian;Si, Anfeng;Zhang, Baohua
通讯作者：
Zhang, Baohua
影响因子：
2.9
作者：
Margonis, Georgios Antonios;Gani, Faiz;Pawlik, Timothy M.
通讯作者：
Pawlik, Timothy M.
影响因子：
3.2
作者：
Park, Joon Seong;Yoon, Dong Sup;Kim, Byong Ro
通讯作者：
Kim, Byong Ro
影响因子：
9
作者：
Shindoh J;de Aretxabala X;Aloia TA;Roa JC;Roa I;Zimmitti G;Javle M;Conrad C;Maru DM;Aoki T;Vigano L;Ribero D;Kokudo N;Capussotti L;Vauthey JN
通讯作者：
Vauthey JN