Decision of surgical approach for advanced gallbladder adenocarcinoma based on a Bayesian network

Cong, Longlong; Cai, Zhiqiang; Guo, Ping; Chen, Chen; Liu, Dechun; Li, Wenzhi; Wang, Lin; Zhao, Yaling; Si, Shubin; Geng, Zhimin

doi:10.1002/jso.24797

Cited by 13 publications

(9 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given the poor prognosis of gallbladder SRC, it is necessary to find an optimal treatment strategy. Total tumor excision with adjuvant chemoradiotherapy is the mainstay of treatment for gallbladder adenocarcinomas at present [ 27 , 28 ]. However, no standardized protocol and guideline for the treatment of gallbladder SRC are available at present because of the limited number of cases and studies.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the gallbladder

Wang

You

et al. 2021

BMC Gastroenterol

View full text Add to dashboard Cite

Background Signet ring cell carcinoma (SRC) is a rare histological subtype of gallbladder adenocarcinoma. The current study evaluates the clinicopathologic features and prognosis of SRC. Methods Patients with adenocarcinoma of the gallbladder were identified in the Surveillance, Epidemiology, and End Results database from 1973 to 2016. Overall survival (OS) and cancer-specific survival (CSS) of patients who had SRC were compared with those of patients who had non-SRC using Cox regression and propensity score methods. Results Of 22,781 gallbladder adenocarcinomas retrieved, 377 (1.7%) were SRC and the other 22,404 were non-SRC. SRC was more significantly associated with older age, female gender, poor differentiation, advanced tumor stage, lymph node metastasis, distant metastasis, and advanced AJCC stage. The 5-year OS and CSS in the SRC group were 7.2 and 6.5%, respectively, both of which were significantly worse than the 13.2 and 13.3% seen in the SRC group (P = 0.002 and P = 0.012, respectively). This survival disadvantage persisted in multivariable analyses [hazard ratio (HR) = 1.256, P = 0.021 and HR = 1.211, P = 0.036] and after propensity score matching (OS: HR = 1.341, P = 0.012 and CSS: HR = 1.625, P = 0.005). Surgery in combination with chemotherapy improved OS of gallbladder SRC patients compared with surgery alone (HR = 0.726, P = 0.036) or chemotherapy alone (HR = 0.433, P < 0.001). Conclusion Patients with SRC of the gallbladder have distinct clinicopathological features with poor prognosis. Surgery in combination with chemotherapy can improve survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the gallbladder

Wang

You

et al. 2021

BMC Gastroenterol

View full text Add to dashboard Cite

show abstract

“…Given the poor prognosis of gallbladder SRC, it is necessary to nd an optimal treatment strategy. Total tumor excision with adjuvant chemoradiotherapy is the mainstay of treatment for gallbladder adenocarcinomas at present [27,28]. However, no standardized protocol and guideline for the treatment of gallbladder SRC are available at present because of the limited number of cases and studies.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics and Prognosis of Signet Ring Cell Carcinoma of the Gallbladder

You

Zhou

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Signet ring cell carcinoma (SRC) is a rare histological subtype of gallbladder adenocarcinoma. The current study evaluates the clinicopathologic features and prognosis of SRC.Methods Patients with adenocarcinoma of the gallbladder were identified in the Surveillance, Epidemiology, and End Results database from 1973 to 2016. Overall survival (OS) was assessed using Cox regression method.Results Of 22,781 gallbladder adenocarcinomas retrieved, 377 (1.7%) were SRC and the other 22,404 were non-SRC. SRC was more significantly associated with older age, female gender, poor differentiation, advanced tumor stage, lymph node metastasis, distant metastasis, and advanced AJCC stage. The 1-, 2- and 5-year OS was 28.1%, 16.8% and 7.2% for SRC vs. 34.9%, 23.1% and 13.2% for non-SRC, respectively (P = 0.002). Multivariable analysis showed that the SRC histology was independently associated with a dismal prognosis (hazard ratio [HR] 1.256, P = 0.021). Surgery in combination with chemotherapy improved OS of gallbladder SRC patients compared with surgery alone (HR 0.726, P = 0.036) or chemotherapy alone (HR 0.433, P < 0.001). Conclusion Patients with SRC of the gallbladder have distinct clinicopathological features with poor prognosis. Surgery in combination with chemotherapy can improve survival.

show abstract

“…For example, it is possible to evaluate the effect of a dose reduction on the risk of digestive toxicity for a specific patient. It is noteworthy that Bayesian networks have been successfully used in medicine to predict various conditions such as hip fracture in the elderly, or elevated aldosterone‐to‐renin ratio , and are increasingly used in oncology .…”

Section: Discussionmentioning

confidence: 99%

Prediction of docetaxel toxicity in older cancer patients: a Bayesian network approach

Khayi

Lafarge

Terret

et al. 2019

Fundamemntal Clinical Pharma

View full text Add to dashboard Cite

Chemotherapy is an essential therapy in the fight against cancer. Polypathology and polymedication are often encountered in elderly patients, making this population especially at risk for adverse drug reactions, and particularly with cytotoxic drugs. The objective of this study was to build a model to predict high‐grade toxicity in elderly patients treated with docetaxel. Data from the trial TAX‐108 have been used to create the model. The variable to predict was the occurrence of grade 3 or 4 toxicity. The explanatory variables entered in the model were anthropometric and biological characteristics of patients at inclusion; fragility criteria (SMAF, CIRS‐G, performance status); location of the primary tumor; chemotherapy history, radiotherapy or surgery; weekly dose of docetaxel, cumulative dose administered. A Bayesian network model was developed using a global search procedure and an Expectation–Maximization algorithm. A 10‐fold cross‐validation was performed. A toxicity of grade 3 or higher was observed in 54% of patients. The variables providing the most information were the primary site (19.4%), the dose per course (17.5%), and albuminemia (13.1%). The area under the curve of the model obtained after cross‐validation was 74 ± 1.4%. The model built allows classifying correctly 71.21 ± 0.9% of patients in our sample in the cross‐validation procedure. The sensitivity and specificity of the model were 75 and 67%, respectively, and the positive and negative predictive values were 73 and 69%. The encouraging results from this first study show that Bayesian networks could help assess the benefit–risk ratio of chemotherapy in elderly patients.

show abstract

Decision of surgical approach for advanced gallbladder adenocarcinoma based on a Bayesian network

Abstract: These BN models indicate that stages T4 and N2 gallbladder adenocarcinoma are not contraindications for surgery and that R0 resection can improve survival in patients with advanced gallbladder adenocarcinoma.

Cited by 13 publications

References 36 publications

Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the gallbladder

Clinicopathological characteristics and prognosis of signet ring cell carcinoma of the gallbladder

Clinicopathological Characteristics and Prognosis of Signet Ring Cell Carcinoma of the Gallbladder

Prediction of docetaxel toxicity in older cancer patients: a Bayesian network approach

Contact Info

Product

Resources

About