Background:Gallbladder cancer (GBC) is a rare and aggressive malignancy with poor prognosis and high recurrence rates, even after curative surgical resection. Early recurrence, defined as recurrence within one year after surgery, remains a major clinical concern. This study aimed to identify preoperative prognostic factors and develop a predictive model for early recurrence and overall survival in resected GBC patients.Methods:We retrospectively analyzed data from 251 patients who underwent curative-intent resection for GBC between 2008 and 2017. Logistic regression was used to identify preoperative factors associated with early recurrence. Significant variables were used to construct a nomogram, which was externally validated using a cohort of 176 patients from three independent tertiary centers.Results:The independent predictors of early recurrence included male sex, chronic liver disease, preoperative symptoms, elevated carcinoembryonic antigen (CEA), sarcopenic obesity, clinical T3 or higher stage, and suspected metastatic lymph nodes. The nomogram demonstrated strong predictive performance with an AUC of 0.872 (95% CI: 0.817–0.927) in internal validation and 0.703 (95% CI: 0.613–0.793) in external validation.Conclusions:We developed and externally validated a novel nomogram that predicts early recurrence in GBC using only preoperative factors. This model may support individualized risk assessment and aid surgeons and patients in shared decision-making prior to high-risk surgery.
背景：胆囊癌是一种罕见且侵袭性强的恶性肿瘤，预后较差，即使在根治性手术切除后复发率仍较高。早期复发，即术后一年内复发，仍是临床关注的主要问题。本研究旨在确定术前预后因素，并构建一个预测模型，用于评估已切除胆囊癌患者的早期复发和总生存期。 方法：我们回顾性分析了2008年至2017年间接受根治性切除的251例胆囊癌患者的数据。采用逻辑回归分析确定与早期复发相关的术前因素。利用显著变量构建列线图，并通过来自三个独立三级医疗中心的176例患者队列进行外部验证。 结果：早期复发的独立预测因素包括男性、慢性肝病、术前症状、癌胚抗原升高、肌肉减少性肥胖、临床T3或更高分期以及可疑转移淋巴结。列线图在内部验证中表现出较强的预测性能，AUC为0.872（95% CI：0.817–0.927），在外部验证中AUC为0.703（95% CI：0.613–0.793）。 结论：我们开发并外部验证了一种仅基于术前因素预测胆囊癌早期复发的新型列线图。该模型可能支持个体化风险评估，并有助于外科医生和患者在高风险手术前进行共同决策。
肿瘤(癌症)患者之家