Assessment of nodal staging and risk factors for nodal involvement in gallbladder cancer

作者：Anita Balakrishnan, Petros Barmpounakis, Nikolaos Demiris, Bodil Andersson, Alejandro Brañes, X. De Aretxabala, Malin Sternby Eilard, Paul Gibbs, Simon Harper, Emmanuel Huguet, Asif Jah, Vasilis Kosmoliaptsis, Javier Lendoire, Siong S Liau, Shishir K. Maithel, Jack L. Martin, Colin Noel, Raaj Praseedom, Alejandro Serrablo, Volkan Adsay, the OMEGA Study Investigators, Tomoyuki Abe, Moh'd Abu Hilal, Maria del Mar Achalandabaso Boira, Mustapha Adham, Mohamed Adam, Maryam Ahmad, Bilal Al‐Sarireh, Maite Albiol, Nassir Alhaboob, Adnan Alseidi, Houssem Ammar, Akshay Anand, Bodil Andersson, Pantelis Antonakis, Verónica Araya, Stanley W. Ashley, Georgi Atanasov, Fabio Ausania, Ricardo Balestri, Abhirup Banerjee, Sudeep Banerjee, Simon Banting, Giedrius Barauskas, F. Bartsch, Andrea Belli, Simona Beretta, Frederik Berrevoet, Ramesh Singh Bhandari, Gerardo Blanco‐Fernández, Louisa Bolm, Mathieu Bonal, Emre Bozkurt, Andries E. Braat, Luke Bradshaw, Konstantinos Bramis, Alejandro Brañes, Lyle Burdine, Matthew Byrne, Maria Caceres, Maria Jesús Castro Santiago, Benjamin Chan, Lynn Chong, Ahmet Çöker, María Conde Rodríguez, Daniel Croagh, Alyn Crutchley, Carmen Cutolo, Mathieu D’Hondt, D.M. D'Souza, Freek Daams, Raffaele Dalla Valle, José Davide, Mario De Bellis, M. de Boer, Céline De Meyere, Philip de Reuver, Matthew Dixon, Panagiotis Dorovinis, Gabriela Echeverría Bauer, Maria Eduarda, Hasan H. Eker, Joris I. Erdmann, Mert Erkan, Evangelos Felekouras, Emanuele Felli, Eduardo Fernandes, Eduardo Figueroa Rivera, Andras Fulop, Daniel Galun, Michael F. Gerhards, Poya Ghorbani, Fabio Giannone, Luis Gil, Emmanouil Giorgakis, Mario Giuffrida, Felice Giuliante, Ioannis Gkekas, Miguel Ángel Gómez‐Bravo, Bas Groot Koerkamp, Óscar Guevara, Alfredo Guglielmi, Aistė Gulla, Rahul Gupta, Amit Gupta, Marta Gutiérrez, Abu Bakar Hafeez Bhatti, Jeroen Hagendoorn, Zain Hajee, Abdul Hakeem, Hytham K. S. Hamid, S. Z. Sayed Hassen, Stefan Heinrich, Roberto Hernandez‐Alejandro, Ryota Higuchi, Daniel Hoffman, David Holroyd, Daniel Hughes, Arpad Ivanecz, Satheesh Iype, Isabel Jaén-Torrejimeno, Shantanu Joglekar, Robert Jones, Klaus Kaczirek, Harsh Kanhere, Ambareen Kausar, Zhanyi Kee, Jessica M. Keilson, Jörg Kleef, Johannes Klose, Brett Knowles, Jun Kit Koong, Nagappan Kumar, Supreeth Kunnuru, Paleswan Joshi Lakhey, Andrea Laurenzi, Yeong Sing Lee, Felipe León, Voon Meng Leow, Jean-Baptiste Lequeu, Mickaël Lesurtel, Elisabeth Lo, Stefan Löb, Elizabeth Lockie, J. Peter A. Lodge, Dolores López Garnica, Víctor López‐López, Linda Lundgren, Nikolaos Machairas, Dhiresh Kumar Maharjan, Deep J. Malde, Marc M. Mankarious, Guillaume Martel, Julie Martin, Michele Mazzola, Arianeb Mehrabi, R. Méméo, Flavio Milana, George Molina, Leah Monette, Haluk Morgül, Dimitrios Moris, Antonios Morsi-Yeroyannis, Nicholas Mowbray, Francesk Mulita, Edoardo Maria Muttillo, Malith Nandasena, Pueya Rashid Nashidengo, Arash Nickkholgh, Colin Noel, Masayuki Ohtsuka, Artūrs Ozoliņš, Sanjay Pandanaboyana, Νικόλαος Παραράς, Alessandro Parente, June S. Peng, Arkaitz Perfecto Valero, Julie Périnel, Konstatinos Perivoliotis, Teresa Perra, Patrick Pessaux, Natalie Petruch, Gaetano Piccolo, László Piros, Alberto Porcu, Viswakumar Prabakaran, Rajendra Prasad, Mikel Prieto Calvo, Florian Primavesi, Eva María Pueyo Périz, Alberto Quaglia, José Manuel Ramia, Ashwin Rammohan, Francesco Razionale, Ricardo Robles Campos, Manas Kumar Roy, Sophie Rozwadowski, Luis I. Ruffolo, Natalia Ruiz, Andrea Ruzzenante, Lily V. Saadat, Mohamed Amine Said, Edoardo Saladino, Gabriel Saliba, Per Sandström, Carlo Alberto Schena, Anthony J. Scholer, Christoph Schwarz, Lorenzo Serafini, Leyre Serrablo, Pablo E. Serrano, Deepak Sharma, Aali J. Sheen, Vishwanath Siddagangaiah, Michael Silva, Saurabh Singh, Ajith K. Siriwardena, Michał Skalski, Mante Smig, Faris Soliman, Abhinav Arun Sonkar, Donzília Sousa Silva, Ernesto Sparrelid, Harry Spiers, Parthi Srinivasan, Malin Sternby Eilard, Oliver Strobel, Urban Stupan, Miguel Ángel Suárez Muñóz, Manisekar Subramaniam, Teiichi Sugiura, Robert Sutcliffe, Hilko A. Swank, Shibojit Talukder, Lillian Taylor, Prabin Thapa, Catherine Teh, Asara Thepbunchonchai, Caman Thieu, Navneet Tiwari, Guido Torzilli, Chutwichai Tovikkai, Blaž Trotovšek, Savvas Tsaramanidis, Georgios Tsoulfas, Katsuhiko Uesaka, Garzali Umar, Lucio Urbani, Michail Vailas, Ronald M. van Dam, Peter van de Boezem, Stijn van Laarhoven, Tomas Vanagas, Mike van Dooren, Manon Viennet, Luca Viganò, Aarathi Vijayashanker, Celia Villodre, Toshifumi Wakai, Aklile Workneh, Li Xu, Masakazu Yamamoto, Zhiying Yang, Robert J. Young, M Zivanovic · 发表于：BJS Open · 年份：2025 · DOI：10.1093/bjsopen/zraf056 · 被引用次数：5 · 研究领域：Cholangiocarcinoma and Gallbladder Cancer Studies、Hepatocellular Carcinoma Treatment and Prognosis、Gallbladder and Bile Duct Disorders

BACKGROUND: Nodal assessment in gallbladder cancer remains challenging, particularly in incidental gallbladder cancer. This understages the number of patients with node-positive disease, resulting in prognostic inaccuracy and insufficient adjuvant treatment. This study aimed to identify risk factors for positive nodes in gallbladder cancer and to compare prognostic discrimination of available nodal staging parameters. METHODS: This international cohort study assessed gallbladder cancer resections undertaken between 1 January 2010 and 31 December 2020. Logistic regression was used to identify risk factors for node-positive status and develop a risk prediction score for positive nodes. Nodal staging models, including nodal site, number of positive nodes, and positive node ratio were compared for greatest prognostic discrimination in gallbladder cancer. RESULTS: A total of 3676 patients underwent gallbladder cancer resection across 133 centres in 41 countries. Tumour (T) stage (T2, P = 0.012; T3, P = 0.002; and T4, P < 0.001), lymphovascular and perineural infiltration (P < 0.001), and tumour differentiation (P < 0.001) carried the greatest risk of positive nodes. These three parameters comprised the OMEGA Node Positivity Prediction Score (OMEGA-NOPPS) with C-statistics of 0.81 (95% confidence interval 0.78 to 0.84) in the training data set and 0.79 (0.73 to 0.85) in the test data set for identification of node-positive status, highlighting a ≥ 20% increased risk of positive nod...