AUTHOR=Cao Peng , Hong Haijie , Yu Zijian , Chen Guodong , Qi Shuo 

TITLE=A Novel Clinically Prognostic Stratification Based on Prognostic Nutritional Index Status and Histological Grade in Patients With Gallbladder Cancer After Radical Surgery

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.850971

DOI=10.3389/fnut.2022.850971

ISSN=2296-861X

ABSTRACT=Purpose: Gallbladder carcinoma (GBC) is the most common malignancy of the biliary tract with a 5-year survival rate of 5%. The prognostic models to predict the prognosis of GBC patients remain controversial. Therefore, in order to construct a prognosis prediction of GBC, we conducted a retrospective cohort study of patients with GBC to investigate nutritional index and histological grade in long-term outcome.
Methods: We conducted a retrospective study in a total of 198 patients with GBC who underwent surgical treatment were enrolled. The hematological indicators, imaging data and perioperative clinical data were acquired.
Results: In multivariate analysis, prognostic nutrition index (PNI) < 45.88, maximum tumor diameter (MTD) > 2.24cm, and Jaundice (JD) were associated with poor prognosis. The prognosis prediction model was based on the three risk factors, which indicated a good predictive ability in primary cohort (AUC = 0.951) and validation cohort (AUC = 0.888). In addition, KM survival analysis suggested that a radical surgery for GCB with a high-risk score and poorly differentiation had a better prognosis (P < 0.05), but there was no significant difference in prognosis for high and moderate differentiation or low-risk score after radical surgery (P > 0.05). 
Conclusions: Our prediction model for GBC with prognosis is accurate and effective. Patients with poorly differentiation and high-risk score, a radical surgery is highly recommended; a routine cholecystectomy also can be considered for acceptance for the patients with high and moderate differentiation or low-risk score.