Abstract

BACKGROUND: The optimal time interval to define early recurrence (ER) among patients who underwent resection of gallbladder cancer (GBC) is not well defined. We soughtto develop and validate a novel GBC recurrence risk (GBRR) score to predict ER among patients undergoing resection for GBC.PATIENTS AND METHODS: Patients who underwent curative-intent resection for GBC between 2000 and 2018 were identified from the US Extrahepatic Biliary Malignancy Consortiumdatabase. A minimum p value approach in the log-rank test was used to define the optimal cutoff forER. A risk stratification model was developed to predict ER based on relevant clinicopathological factors and was externally validated.RESULTS: Among 309 patients, 103 patients (33.3%) had a recurrence at a median follow-up period of 15.1months. The optimal cutoff for ER was defined at 12months (p=3.04*10-18). On multivariable analysis, T3/T4 disease (HR: 2.80; 95% CI 1.58-5.11) and poor tumordifferentiation (HR: 1.91; 95% CI 1.11-3.25) were associated with greater hazards of ER. The GBRR score was developed using beta-coefficients of variables in the final model, and patients were classified into three distinct groups relative to the risk forER (12-month RFS; low risk: 88.4%, intermediate risk: 77.9%, high risk: 37.0%, p<0.001). The external validation demonstrated good model generalizability with good calibration (n=102: 12-month RFS; low risk: 94.2%, intermediate risk: 59.8%, high risk: 42.0%, p<0.001). The GBRR score is available online at https://ktsahara.shinyapps.io/GBC_earlyrec/ .CONCLUSIONS: A novel online calculator was developed to help clinicians predict the probability of ER after curative-intent resection for GBC. The proposed web-based tool may help in the optimization of surveillance intervals and the counselling of patients about their prognosis.

View details for DOI 10.1245/s10434-020-09108-y

View details for PubMedID 32892270