Cancer Management and Research (Nov 2020)

Preoperative Immune Prognostic Index Can Predict the Clinical Outcomes of Patients with Gallbladder Cancer: Single-Center Experience

  • Sun L,
  • Wang D,
  • Zhang M,
  • Jin Y,
  • Jin B,
  • Xu H,
  • Du S,
  • Xu Y,
  • Zhao H,
  • Lu X,
  • Sang X,
  • Zhong S,
  • Yang H,
  • Mao Y

Journal volume & issue
Vol. Volume 12
pp. 12137 – 12150

Abstract

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Lejia Sun,1,* Dongyue Wang,2,* Mengyuan Zhang,2,* Yukai Jin,1 Bao Jin,1 Haifeng Xu,1 Shunda Du,1 Yiyao Xu,1 Haitao Zhao,1 Xin Lu,1 Xinting Sang,1 Shouxian Zhong,1 Huayu Yang,1 Yilei Mao1 1Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China; 2Peking Union Medical College (PUMC), PUMC & Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yilei Mao; Huayu YangDepartment of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of ChinaTel +86-10-69156042Email [email protected]; [email protected]: The immune prognostic index (IPI) has been used as a prognostic biomarker in various cancers. However, the prognostic value of the IPI in gallbladder cancer remains to be determined.Patients and Methods: This study included 139 patients who were diagnosed with gallbladder cancer after surgical resection from 2003 to 2017. We used a Kaplan–Meier curve analysis to evaluate the overall survival (OS). Cox proportional hazards regression methodology was used to identify significant independent prognostic factors. Prognostic nomograms for predicting OS were established to achieve superior discriminatory abilities. The prognostic nomograms were verified according to the concordance index, calibration curves, and decision curve analyses in the training cohort and validation cohort.Results: Of all 139 patients, 87 (62.6%) patients accepted R0 resection, 32% and 68% were stratified into the good and poor IPI group, respectively. The median OS was 55.9 (range, 5.93– 182.7) months in the good IPI group and 15.47 (range, 0.29– 190.37) months in the poor IPI group (P < 0.001). In the multivariate Cox model, the IPI was an independent predictor of OS along with the CA19-9, curative resection, and postoperative chemoradiotherapy. A nomogram based on these factors was efficient in predicting 1-, 3-, and 5-year survival probabilities. The nomogram showed higher sensitivity and specificity than the current cancer TNM staging system in the training cohort and validation cohort.Conclusion: The IPI is an independent prognostic factor in gallbladder cancer. Our IPI-based nomogram can serve as a useful and convenient prognostic tool for gallbladder cancer.Keywords: the immune prognostic index, gallbladder cancer, prognostic value, nomogram, overall survival

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