Efficacy of the Gallbladder Cancer Predictive Risk Score Based on Pathological Findings: A Propensity Score-Matched Analysis

  • Tetsuya Mochizuki
  • Tomoyuki Abe
  • Hironobu Amano
  • Keiji Hanada
  • Minoru Hattori
  • Tsuyoshi Kobayashi
  • Masahiro Nakahara
  • Hideki Ohdan
  • Toshio Noriyuki
Hepatobiliary Tumors

Abstract

Background

The optimal prognostic predictive system for gallbladder carcinoma (GBC) has not been established. The gallbladder cancer predictive risk score (GBRS) based on pathological findings identifies incidental GBC patients at risk of recurrence.

Objective

We aimed to validate the prognostic ability of the GBRS in all GBC patients following curative surgery.

Methods

Fifty-six patients with GBC who underwent curative surgery between 1996 and 2016 were included in this study. Univariate and multivariate analyses were performed to determine prognostic factors associated with overall and recurrence-free survival, and propensity score-matched analysis was performed.

Results

The median patient age was 71.9 years, and 39.3% of patients were males. All patients underwent curative surgery (33.9%, simple cholecystectomy; 66.1%, more advanced procedures, such as hepatectomy; and 32.1%, bile duct reconstruction). On univariate analysis, preoperative carbohydrate antigen 19-9 (CA19–9) ≥ 37 U/mL (p = 0.042), postoperative complications (p = 0.043), and a high GBRS (p < 0.001) were prognostic factors for worse overall survival. On multivariate analysis, CA19–9 ≥ 37 U/mL (p = 0.039 and p = 0.043, respectively) and a high GBRS (p = 0.001 and p = 0.010, respectively) were independent risk factors for poor overall and recurrence-free survival. After propensity score-matched analysis, the GBRS precisely predicted prognosis of patients with GBC.

Conclusions

The GBRS is an easy and novel prognostic predicting score. Our validation revealed good discrimination, suggesting its clinical utility to improve individualized prediction of survival for patients undergoing resection of GBC.

Notes

Acknowledgment

The authors would like to thank the Center of Life Science at Hiroshima University for the use of their facilities.

Disclosure

There is no conflict of interest to disclose.

Informed Consent

Informed consent was obtained from all individual participants included in this study.

Supplementary material

10434_2018_6444_MOESM1_ESM.pdf (220 kb)
Supplementary material 1 (PDF 220 kb)
10434_2018_6444_MOESM2_ESM.doc (44 kb)
Supplementary material 2 (DOC 43 kb)

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Tetsuya Mochizuki
    • 1
  • Tomoyuki Abe
    • 1
  • Hironobu Amano
    • 1
    • 4
  • Keiji Hanada
    • 2
  • Minoru Hattori
    • 3
  • Tsuyoshi Kobayashi
    • 4
  • Masahiro Nakahara
    • 1
  • Hideki Ohdan
    • 4
  • Toshio Noriyuki
    • 1
    • 4
  1. 1.Department of SurgeryOnomichi General HospitalOnomichiJapan
  2. 2.Department of GastroenterologyOnomichi General HospitalOnomichiJapan
  3. 3.Advanced Medical Skill Training Center, Institute of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
  4. 4.Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan

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