摘要
We read the study reported by Lohman et al.with interest published recently in the Annals of Surgery(1).The authors have developed a statistical model to predict the overall survival(OS)of patients with resected gall bladder cancer(GBC).Dutch national database was used to create and internally validate the model based on individual-level data(n=380).Subsequently,data from a cohort of Australian patients with resected GBC were used for external validation(n=66).The model was constructed based on the patient and tumor characteristics found to be independent predictors of OS that included age,tumor and node(T/N)classification,resection margin,tumor differentiation grade,and vascular invasion.The concordance index(C-index)in the internal and the external validation cohorts were 0.71[95%confidence interval(CI):0.69-0.72]and 0.75(95%CI:0.69-0.80),respectively,suggesting good discriminatory capacity.The authors also demonstrated that their model outperformed the discriminative capability of the American Joint Committee on Cancer(AJCC)staging system(8th edition)with a C-index of 0.59(95%CI:0.57-0.60).Furthermore,the authors constructed a web application that can predict the OS of a given patient based on a small number of clinicopathologic variables(age,T stage,N stage,resection margin,differentiation grade,and perivascular invasion).
