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Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2008 May 01; Vol. 26 (13), pp. 2112-7. Date of Electronic Publication: 2008 Mar 31. - Publication Year :
- 2008
-
Abstract
- Purpose: The benefit of adjuvant radiotherapy (RT) for gallbladder cancer remains controversial because most published data are from small, single-institution studies. The purpose of this study was to construct a survival prediction model to enable individualized predictions of the net survival benefit of adjuvant RT for gallbladder cancer patients based on specific tumor and patient characteristics.<br />Methods: A multivariate Cox proportional hazards model was constructed using data from 4,180 patients with resected gallbladder cancer diagnosed from 1988 to 2003 from the Surveillance, Epidemiology, and End Results database. Patient and tumor characteristics were included as covariates and assessed for association with overall survival (OS) with and without adjuvant RT. The model was internally validated for discrimination and calibration using bootstrap resampling.<br />Results: On multivariate regression analysis, the model showed that age, sex, papillary histology, stage, and adjuvant RT were significant predictors of OS. The survival prediction model demonstrated good calibration and discrimination, with a bootstrap-corrected concordance index of 0.71. The model predicts that adjuvant RT provides a survival benefit in node-positive or >or= T2 disease. A nomogram and a browser-based software tool were built from the model that can calculate individualized estimates of predicted net survival gain attributable to adjuvant RT, given specific input parameters.<br />Conclusion: In the absence of large, prospective, randomized, clinical trial data, a regression model can be used to make individualized predictions of the expected survival improvement from the addition of adjuvant RT after gallbladder cancer resection.
- Subjects :
- Adult
Age Factors
Aged
Aged, 80 and over
Decision Making, Computer-Assisted
Female
Gallbladder Neoplasms pathology
Gallbladder Neoplasms surgery
Humans
Male
Middle Aged
Neoplasm Staging
Nomograms
Patient Selection
Predictive Value of Tests
Proportional Hazards Models
Radiotherapy, Adjuvant
Reproducibility of Results
SEER Program
Sex Factors
Survival Analysis
Treatment Outcome
United States
Gallbladder Neoplasms mortality
Gallbladder Neoplasms radiotherapy
Models, Biological
Subjects
Details
- Language :
- English
- ISSN :
- 1527-7755
- Volume :
- 26
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 18378567
- Full Text :
- https://doi.org/10.1200/JCO.2007.14.7934