A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder Cancer
Objective: Gallbladder cancer (GBC) is one of the most aggressive malignant tumors, and there is no effective and convenient method for predicting cancer-specific survival (CSS). We aim to develop a novel nomogram staging system based on the positive lymph node ratio (pLNR) for GBC patients.Methods:...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.01281/full |
| _version_ | 1818108630819405824 |
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| author | Yongcong Yan Yongcong Yan Jianhong Lin Jianhong Lin Mengyu Zhang Haohan Liu Haohan Liu Qianlei Zhou Qianlei Zhou Ruibin Chen Ruibin Chen Kai Wen Kai Wen Jie Wang Zhiyu Xiao Kai Mao |
| author_facet | Yongcong Yan Yongcong Yan Jianhong Lin Jianhong Lin Mengyu Zhang Haohan Liu Haohan Liu Qianlei Zhou Qianlei Zhou Ruibin Chen Ruibin Chen Kai Wen Kai Wen Jie Wang Zhiyu Xiao Kai Mao |
| author_sort | Yongcong Yan |
| collection | DOAJ |
| description | Objective: Gallbladder cancer (GBC) is one of the most aggressive malignant tumors, and there is no effective and convenient method for predicting cancer-specific survival (CSS). We aim to develop a novel nomogram staging system based on the positive lymph node ratio (pLNR) for GBC patients.Methods:A total of 1,356 patients enrolled in the study. We evaluated the prognostic value of the pLNR and built a prognostic nomogram staging system based on the pLNR in the training cohort. The concordance index and calibration plots were used to evaluate model discrimination. The predictive accuracy and clinical value of the nomograms were measured by decision curve analysis (DCA). The CSS nomogram was further validated in an internal validation cohort.Results:The pLNR was an independent prognostic factor for CSS based on Cox regression analyses. A prognostic nomogram that combined T classification, pLNR, M classification, histologic grade, live metastasis, and tumor size was formulated with a c-index of 0.763 (95% CI, 0.728–0.798), while the c-indexes for the staging system of AJCC 8th, 7th, and 6th for CSS prediction were 0.718, 0.718, and 0.717, respectively. The calibration curves showed perfect agreement. The DCA showed that the nomogram provided substantial clinical value. The nomogram (the AUCs for 1, 3, and 5 years were 0.693, 0.716, and 0.726, respectively,) showed high prognostic accuracy.Conclusion:We have developed a formulated nomogram staging system based on the pLNR that allows more accurate individualized predictions of CSS for resected GBC patients than the AJCC staging systems. |
| first_indexed | 2024-12-11T02:18:25Z |
| format | Article |
| id | doaj.art-6e415e4ec7e746d0b777de805c04f250 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-11T02:18:25Z |
| publishDate | 2020-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-6e415e4ec7e746d0b777de805c04f2502022-12-22T01:24:07ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-07-011010.3389/fonc.2020.01281496746A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder CancerYongcong Yan0Yongcong Yan1Jianhong Lin2Jianhong Lin3Mengyu Zhang4Haohan Liu5Haohan Liu6Qianlei Zhou7Qianlei Zhou8Ruibin Chen9Ruibin Chen10Kai Wen11Kai Wen12Jie Wang13Zhiyu Xiao14Kai Mao15Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, ChinaObjective: Gallbladder cancer (GBC) is one of the most aggressive malignant tumors, and there is no effective and convenient method for predicting cancer-specific survival (CSS). We aim to develop a novel nomogram staging system based on the positive lymph node ratio (pLNR) for GBC patients.Methods:A total of 1,356 patients enrolled in the study. We evaluated the prognostic value of the pLNR and built a prognostic nomogram staging system based on the pLNR in the training cohort. The concordance index and calibration plots were used to evaluate model discrimination. The predictive accuracy and clinical value of the nomograms were measured by decision curve analysis (DCA). The CSS nomogram was further validated in an internal validation cohort.Results:The pLNR was an independent prognostic factor for CSS based on Cox regression analyses. A prognostic nomogram that combined T classification, pLNR, M classification, histologic grade, live metastasis, and tumor size was formulated with a c-index of 0.763 (95% CI, 0.728–0.798), while the c-indexes for the staging system of AJCC 8th, 7th, and 6th for CSS prediction were 0.718, 0.718, and 0.717, respectively. The calibration curves showed perfect agreement. The DCA showed that the nomogram provided substantial clinical value. The nomogram (the AUCs for 1, 3, and 5 years were 0.693, 0.716, and 0.726, respectively,) showed high prognostic accuracy.Conclusion:We have developed a formulated nomogram staging system based on the pLNR that allows more accurate individualized predictions of CSS for resected GBC patients than the AJCC staging systems.https://www.frontiersin.org/article/10.3389/fonc.2020.01281/fullgallbladder cancerpositive lymph node ratiocancer-specific survivalnomogramdecision curve analysissurveillance |
| spellingShingle | Yongcong Yan Yongcong Yan Jianhong Lin Jianhong Lin Mengyu Zhang Haohan Liu Haohan Liu Qianlei Zhou Qianlei Zhou Ruibin Chen Ruibin Chen Kai Wen Kai Wen Jie Wang Zhiyu Xiao Kai Mao A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder Cancer Frontiers in Oncology gallbladder cancer positive lymph node ratio cancer-specific survival nomogram decision curve analysis surveillance |
| title | A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder Cancer |
| title_full | A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder Cancer |
| title_fullStr | A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder Cancer |
| title_full_unstemmed | A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder Cancer |
| title_short | A Novel Staging System to Forecast the Cancer-Specific Survival of Patients With Resected Gallbladder Cancer |
| title_sort | novel staging system to forecast the cancer specific survival of patients with resected gallbladder cancer |
| topic | gallbladder cancer positive lymph node ratio cancer-specific survival nomogram decision curve analysis surveillance |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.01281/full |
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