Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer

Samuel Wang, C. David Fuller, Jong Sung Kim, Dean F. Sittig, Charles Thomas, Peter M. Ravdin

Research output: Contribution to journalArticle

87 Citations (Scopus)

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. 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. 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 ≥ 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. 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.

Original languageEnglish (US)
Pages (from-to)2112-2117
Number of pages6
JournalJournal of Clinical Oncology
Volume26
Issue number13
DOIs
StatePublished - 2008

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Gallbladder Neoplasms
Adjuvant Radiotherapy
Survival
Calibration
Nomograms
Proportional Hazards Models
Neoplasms
Histology
Epidemiology
Software
Multivariate Analysis
Randomized Controlled Trials
Regression Analysis
Databases

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer. / Wang, Samuel; Fuller, C. David; Kim, Jong Sung; Sittig, Dean F.; Thomas, Charles; Ravdin, Peter M.

In: Journal of Clinical Oncology, Vol. 26, No. 13, 2008, p. 2112-2117.

Research output: Contribution to journalArticle

Wang, Samuel ; Fuller, C. David ; Kim, Jong Sung ; Sittig, Dean F. ; Thomas, Charles ; Ravdin, Peter M. / Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 13. pp. 2112-2117.
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