AUTHOR=Fan Zizheng , Liu Bing , Shang Peizhong 

TITLE=Development and validation of a nomogram prediction model based on albumin-to-alkaline phosphatase ratio for predicting the prognosis of gallbladder carcinoma

JOURNAL=Pathology and Oncology Research

VOLUME=Volume 28 - 2022

YEAR=2023

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2022.1610818

DOI=10.3389/pore.2022.1610818

ISSN=1532-2807

ABSTRACT=Gallbladder carcinoma (GBC) is a rare biliary tract malignancy with a high recurrence rate and poor prognosis. Serum albumin-alkaline phosphatase ratio (AAPR) has been demonstrated to be a prognostic predictor for several malignancies, but its predictive role for patients with GBC is still unclear. In the present study, we aim to investigate the predictive role of AAPR in GBC patients and develop a novel prognostic nomogram for GBC patients after surgery. A total of 80 patients who underwent surgery at the Hospital of 81st Group Army PLA from January 2014 to May 2022 were retrospectively analyzed. The optimal cut-off value of AAPR was determined using X-tile software. A nomogram based on multivariate Cox regression was developed and validated using calibration curves, Harrell’s concordance index, time-dependent receiver operating characteristic curves, and decisive curve analysis. The optimal cut-off value of AAPR was 0.20. Univariate and multivariate Cox proportional hazard analyses demonstrated that AAPR (HR=0.199, P=0.003), BMI (HR=0.41, P=0.041), R0 resection (HR=3.203, P=0.001), TNM stage (HR=5.113, P=0.004) were independent predictors for overall survival (OS). The nomogram integrated these four significant prognostic factors showed considerable prognostic performance in terms of consistency, discrimination, and net benefit. AAPR is an independent predictor of GBC patients undergoing surgery, and a novel nomogram model combining AAPR, BMI, R0 resection, and TNM stage showed superior predictive ability.