Analysis of Prognostic Factors and Establishment of Prediction Model after Radical Operation of Early Gallbladder Carcinoma in Han Population

Lin S, Cai Z, Lin Z, Wang Y, Li T and Lin C

Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Fujian Medical University, China Fujian Abdominal Surgery Research Institute, The First Affiliated Hospital, Fujian Medical University, China National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, China Fujian Medical University Union Hospital, Fujian Medical University, China Department of Oncology, Fujian Provincial Hospital, Provincial Clinical College, Fujian Medical University, China Theses authors contributed equally to this work

^*Correspondance to: Chengjie Lin 

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Abstract:

Primary Gallbladder Carcinoma (GBC) is among one of the gastrointestinal malignancies with extremely dismal prognosis. This study was aimed to investigate the clinical effect and prognostic factors after radical operation of early primary GBC in Han population, and construct prediction model based on prognostic factors. Clinical data of 65 patients with early GBC who underwent radical surgery in our Department from August 24th, 2010 to August 24th, 2021 were collected for this retrospective study. Univariate analysis showed that age, Onodera Prognostic Nutrition Index (OPNI), Neutrophil Lymphocyte Ratio (NLR), CA199, differentiation degree, nerve invasion, T stage, lymphatic metastasis and adjuvant chemotherapy were the risk factors that could affect the prognosis of Han population after early GBC radical surgery (P<0.05). Multivariate analysis showed that age, OPNI, nerve invasion and lymphatic metastasis were independent risk factors for early GBC radical surgery in Han population (P<0.05), and a nomogram was established thereby. The composite survival probability score of each patient was obtained by using the nomogram. The Bootstrap method was used to repeat 1,000 samples for internal verification, and the consistency between OS and reality was high in 2, 3 and 5 years. The Consistency index (C-index) of this model was 0.860 (95% CI 0.822-0.897), and its prediction ability was higher than that of the eighth AJCC staging (C-index 0.820, 95% CI 0.7899-0.851). Therefore, age, OPNI, nerve invasion and lymphatic metastasis are independent risk factors for early GBC radical surgery in Han population. The nomogram model constructed based on the above independent risk factors has high accuracy, which can provide a reference for clinicians to evaluate the prognosis after early GBC radical surgery.

Keywords:

Primary gallbladder carcinoma; Han population; OPNI; Nerve invasion; Nomogram

Cite the Article:

Lin S, Cai Z, Lin Z, Wang Y, Li T, Lin C. Analysis of Prognostic Factors and Establishment of Prediction Model after Radical Operation of Early Gallbladder Carcinoma in Han Population. World J Surg Surgical Res. 2023; 6: 1477..