Nomograms to predict long-term survival for patients with gallbladder carcinoma after resection

Background: Surgical resection remains the primary treatment option for gallbladder carcinoma (GBC). However, there is a pressing demand for prognostic tools that can refine patients’ treatment choices and tailor personalized therapies accordingly. Methods: The nomograms were constructed using the data of a training cohort (n=378) of GBC patients at Eastern Hepatobiliary Surgery Hospital (EHBH) between 2008 and 2018. The model’s performance was validated in GBC patients (n=108) at Guangzhou Centre from 2007 to 2018. Results: The 5-year overall survival (OS) rate in the training cohort was 24.4%. Multivariate analyses were performed using preoperative and postoperative data to identify independent predictors of OS. These predictors were then incorporated into preoperative and postoperative nomograms, respectively. The C-index of the preoperative nomogram was 0.661 (95% CI, 0.627 to 0.694) for OS prediction and correctly delineated four subgroups (5-year OS rates: 48.1%, 19.0%, 15.6%, and 8.1%, p<0.001). The C-index of the postoperative nomogram was 0.778 (95%CI, 0.756–0.800). Furthermore, this nomogram was superior to the 8th TNM system in both C-index and the net benefit on decision curve analysis. The results were externally validated. Conclusions: The two nomograms showed an optimally prognostic prediction in GBC patients after curative-intent resection.