Frontiers in Oncology (Jun 2021)
Development and Validation of a Prognostic Nomogram Based on the Systemic Immune-Inflammation Index for Resectable Gallbladder Cancer to Predict Survival and Chemotherapy Benefit
- Lin Li,
- Lin Li,
- Lin Li,
- Lin Li,
- Tai Ren,
- Tai Ren,
- Tai Ren,
- Ke Liu,
- Ke Liu,
- Ke Liu,
- Ke Liu,
- Mao-Lan Li,
- Mao-Lan Li,
- Mao-Lan Li,
- Ya-Jun Geng,
- Ya-Jun Geng,
- Ya-Jun Geng,
- Ya-Jun Geng,
- Yang Yang,
- Yang Yang,
- Yang Yang,
- Yang Yang,
- Huai-Feng Li,
- Huai-Feng Li,
- Huai-Feng Li,
- Xue-Chuan Li,
- Xue-Chuan Li,
- Xue-Chuan Li,
- Xue-Chuan Li,
- Run-Fa Bao,
- Run-Fa Bao,
- Run-Fa Bao,
- Yi-Jun Shu,
- Yi-Jun Shu,
- Yi-Jun Shu,
- Hao Weng,
- Hao Weng,
- Hao Weng,
- Wei Gong,
- Wei Gong,
- Wei Gong,
- Wan Yee Lau,
- Xiang-Song Wu,
- Xiang-Song Wu,
- Xiang-Song Wu,
- Ying-Bin Liu,
- Ying-Bin Liu,
- Ying-Bin Liu,
- Ying-Bin Liu
Affiliations
- Lin Li
- Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Lin Li
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Lin Li
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Lin Li
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Tai Ren
- Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Tai Ren
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Tai Ren
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Ke Liu
- Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ke Liu
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Ke Liu
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Ke Liu
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Mao-Lan Li
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Mao-Lan Li
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Mao-Lan Li
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ya-Jun Geng
- Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ya-Jun Geng
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Ya-Jun Geng
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Ya-Jun Geng
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yang Yang
- Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yang Yang
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Yang Yang
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Yang Yang
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Huai-Feng Li
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Huai-Feng Li
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Huai-Feng Li
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xue-Chuan Li
- Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xue-Chuan Li
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Xue-Chuan Li
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Xue-Chuan Li
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Run-Fa Bao
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Run-Fa Bao
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Run-Fa Bao
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yi-Jun Shu
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Yi-Jun Shu
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Yi-Jun Shu
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Hao Weng
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Hao Weng
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Hao Weng
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wei Gong
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Wei Gong
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Wei Gong
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wan Yee Lau
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, Hong Kong
- Xiang-Song Wu
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Xiang-Song Wu
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Xiang-Song Wu
- Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ying-Bin Liu
- Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ying-Bin Liu
- Shanghai Key Laboratory of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Ying-Bin Liu
- Shanghai Research Center of Biliary Tract Disease, Renji Hospital, Shanghai, China
- Ying-Bin Liu
- Shanghai Cancer Institute, State Key Laboratory of Oncogenes and Related Genes, Shanghai, China
- DOI
- https://doi.org/10.3389/fonc.2021.692647
- Journal volume & issue
-
Vol. 11
Abstract
ObjectivesTo investigate the prognostic significance of the systemic immune-inflammation index (SII) in patients after radical cholecystectomy for gallbladder cancer (GBC) using overall survival (OS) as the primary outcome measure.MethodsBased on data from a multi-institutional registry of patients with GBC, significant prognostic factors after radical cholecystectomy were identified by multivariate Cox proportional hazards model. A novel staging system was established, visualized as a nomogram. The response to adjuvant chemotherapy was compared between patients in different subgroups according to the novel staging system.ResultsOf the 1072 GBC patients enrolled, 691 was randomly selected in the discovery cohort and 381 in the validation cohort. SII>510 was found to be an independent predictor of OS (hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.42-2.54). Carbohydrate antigen 199(CA19-9), tumor differentiation, T stage, N stage, margin status and SII were involved in the nomogram. The nomogram showed a superior prediction compared with models without SII (1-, 3-, 5-year integrated discrimination improvement (IDI):2.4%, 4.1%, 5.4%, P<0.001), and compared to TNM staging system (1-, 3-, 5-year integrated discrimination improvement (IDI):5.9%, 10.4%, 12.2%, P<0.001). The C-index of the nomogram in predicting OS was 0.735 (95% CI 0.683-0.766). The novel staging system based on the nomogram showed good discriminative ability for patients with T2 or T3 staging and with negative lymph nodes after R0 resection. Adjuvant chemotherapy offered significant survival benefits to these patients with poor prognosis.ConclusionsSII was an independent predictor of OS in patients after radical cholecystectomy for GBC. The new staging system identified subgroups of patients with T2 or T3 GBC with negative lymph nodes who benefited from adjuvant chemotherapy.Clinical Trial RegistrationClinicalTrials.gov, identifier (NCT04140552).
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