Li XF, Ma TT, Li T. Risk factors and survival prediction model establishment for prognosis in patients with radical resection of gallbladder cancer. World J Gastrointest Surg 2024; 16(10): 3239-3252 [PMID: 39575289 DOI: 10.4240/wjgs.v16.i10.3239]
Corresponding Author of This Article
Tao Li, MD, Chief Doctor, Professor, Department of Hepatobiliary Surgery, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Street, Xichen District, Beijing 100044, China. litao3261@pkuph.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Gastrointest Surg. Oct 27, 2024; 16(10): 3239-3252 Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3239
Table 1 Clinical characteristics of patients undergoing curative surgery for gallbladder cancer (n = 93), n (%)
Factor
n = 93
Age (mean ± SD)
64.18 ± 12.05
Age distribution
< 40
2 (2.15)
40-49
9 (9.68)
50-59
23 (24.73)
60-69
21 (22.58)
70-80
32 (34.41)
> 80
6 (6.45)
Sex
Male
38 (40.86)
Female
55 (59.14)
Gallstones
Yes
42 (45.16)
No
51 (54.84)
Hematologic parameters
Red blood cell (1012/L)
4.15 ± 1.82
White blood cell (109/L)
7.60 ± 3.27
Hemoglobin (g/L)
122.62 ± 16.83
Neutrophils (%)
41.04 ± 12.91
Lymphocytes (%)
18.99 ± 10.91
Liver function test
ALT (U/L)
43.71 ± 35.03
AST (U/L)
43.13 ± 40.61
ALP (U/L)
89.15 ± 74.44
ALP (U/L)
71.99 ± 82.92
GGT (U/L)
35.94 ± 6.19
Albumin (g/L)
43.71 ± 35.03
Bilirubin Level
TB (umol/L)
33.84 ± 56.43
DB (umol/L)
6.01 ± 3.62
CA19-9 marker
Positive
41 (44.09)
Negative
52 (55.91)
Adjuvant therapy
Yes
44 (47.31)
No
49 (52.69)
Table 2 Histopathological details of gallbladder patients (n = 93), n (%)
Patient characteristic
n = 93
pT stage
T1-T2
29 (31.18)
T3-T4
64 (68.82)
Lymph node metastasis
N0
54 (58.06)
N1
34 (36.56)
N2
5 (5.38)
Pathological staging (AJCC 8th)
I-II
25 (26.88)
III-IV
68 (73.12)
Degree of tissue differentiation
Well differentiated
25 (26.88)
Moderately differentiated
23 (24.73)
Poorly differentiated
45 (48.39)
Surgical margin
Positive
10 (10.75)
Negative
83 (89.25)
Liver invasion
Positive
43 (46.24)
Negative
50 (53.76)
Extrahepatic bile duct invasion
Positive
36 (38.71)
Negative
57 (61.29)
PNI
Positive
29 (31.18)
Negative
64 (68.82)
LVI
Positive
33 (35.48)
Negative
60 (64.52)
Table 3 Univariate analysis of prognostic factors in patients undergoing radical surgery for gallbladder cancer, n (%)
Factor
Frequency/percentage
HR (95%CI)
P value
Sex
Male
38 (40.9)
-
Female
55 (59.1)
0.75 (0.45-1.23)
P = 0.248
Age
< 57
25 (26.9)
-
≥ 57
68 (73.1)
1.51 (0.84-2.70)
P = 0.165
CA19-9
Negative
52 (55.9)
-
Positive
41 (44.1)
5.05 (2.97-8.60)
P < 0.001
T stage
T1-T2
29 (31.2)
-
T3-T4
64 (68.8)
7.62 (3.44-16.87)
P < 0.001
Lymph node metastasis
N0
54 (58.1)
-
N1
34 (36.6)
4.18 (2.44-7.15)
P < 0.001
N2
5 (5.4)
4.69 (1.79-12.26)
P = 0.002
Differentiation degree
Well-differentiated
25 (26.9)
-
Moderately differentiated
23 (24.7)
10.28 (3.50-30.21)
P < 0.001
Poorly differentiated
45 (48.4)
11.38 (4.03-32.11)
P < 0.001
Surgical margin
Negative
83 (89.2)
-
Positive
10 (10.8)
3.10 (1.54-6.22)
P = 0.002
Liver invasion
Absent
50 (53.8)
-
Present
43 (46.2)
6.91 (3.99-11.97)
P < 0.001
Table 4 Multivariate cox regression analysis
Variable
HR
95%CI
P value
Lymph node metastasis
N1
1.12
0.39-3.22
P = 0.835
N2
1.93
1.07-3.48
P = 0.030
Degree of differentiation
Moderately differentiated
4.08
1.32-12.64
P = 0.015
Poorly differentiated
4.33
1.35-13.89
P = 0.014
Surgical margin
Positive
0.39
0.20-0.74
P = 0.004
Liver invasion
Present
1.97
0.96-4.03
P = 0.063
Extrahepatic bile duct invasion
Present
2.39
1.20-4.77
P = 0.014
Perineural invasion
Present
1.83
1.04-3.22
P = 0.036
Citation: Li XF, Ma TT, Li T. Risk factors and survival prediction model establishment for prognosis in patients with radical resection of gallbladder cancer. World J Gastrointest Surg 2024; 16(10): 3239-3252