Background:Due to absence of large,prospective,randomized,clinical trial data,the potential survivalbenefit of lymphadenectomy with different number of regional lymph nodes(LNs)remains controversial.We aim to create a...Background:Due to absence of large,prospective,randomized,clinical trial data,the potential survivalbenefit of lymphadenectomy with different number of regional lymph nodes(LNs)remains controversial.We aim to create a predicting model to help estimate individualized potential survival benefit oflymphadenectomy with more regional LNs for patients with resected gallbladder cancer(GBC).Methods:Patients with resected GBC were selected from the Surveillance,Epidemiology,and End Resultsdatabase who were diagnosed between 2004 and 2014.Covariates included age,race,sex,grade,histologicalstage,tumor sizes and receipt of non-primary surgery.Two types of multivariate survival regression modelswere constructed and compared.The best model performance was tested by the external validation data fromour hospital.Results:A total of 1,669 patients met the inclusion criteria for this study.The lognormal survival modelshowed the best performance and was tested by the external validation data,including 193 patients withresected GBC from our hospital.Nomograms,which based on the accelerated failure time parametricsurvival model,were built to estimate individualized survival.C-index,was up to 0.754 and 0.710 in internalvalidation for more and less regional LNs removed,respectively.Both of internal and external calibrationcurves showed good agreement between predicted and observed outcomes in the 1-,3-,and 5-year overallsurvival(OS).Conclusions:A predicting model can be used as a decision model to predict which patients may obtainbenefit from lymphadenectomy with more regional LNs.展开更多
基金This work was supported by Key Research and Development Plan Projects of Zhejiang Province(No.2017C01018).
文摘Background:Due to absence of large,prospective,randomized,clinical trial data,the potential survivalbenefit of lymphadenectomy with different number of regional lymph nodes(LNs)remains controversial.We aim to create a predicting model to help estimate individualized potential survival benefit oflymphadenectomy with more regional LNs for patients with resected gallbladder cancer(GBC).Methods:Patients with resected GBC were selected from the Surveillance,Epidemiology,and End Resultsdatabase who were diagnosed between 2004 and 2014.Covariates included age,race,sex,grade,histologicalstage,tumor sizes and receipt of non-primary surgery.Two types of multivariate survival regression modelswere constructed and compared.The best model performance was tested by the external validation data fromour hospital.Results:A total of 1,669 patients met the inclusion criteria for this study.The lognormal survival modelshowed the best performance and was tested by the external validation data,including 193 patients withresected GBC from our hospital.Nomograms,which based on the accelerated failure time parametricsurvival model,were built to estimate individualized survival.C-index,was up to 0.754 and 0.710 in internalvalidation for more and less regional LNs removed,respectively.Both of internal and external calibrationcurves showed good agreement between predicted and observed outcomes in the 1-,3-,and 5-year overallsurvival(OS).Conclusions:A predicting model can be used as a decision model to predict which patients may obtainbenefit from lymphadenectomy with more regional LNs.
