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

作者：Cong, Long-Long; Cai, Zhi-Qiang; Guo, Peng; Chen, Chen; Liu, De-Chun; Li, Wen-Zhi; Wang, Lin; Zhao, Yaling; Si, Shu-Bin^*; Geng, Zhi-Min^*

来源：Journal of Surgical Oncology, 2017, 116(8): 1123-1131.

DOI：10.1002/jso.24797

• Bayesian network model
• gallbladder adenocarcinoma
• predictive model
• surgery
• TNM stage

Background and ObjectivesTo determine whether radical resection can benefit patients with advanced gallbladder adenocarcinoma using a Bayesian network (BN) with clinical data. @@@ MethodsIn total, 362 patients who had undergone surgical treatment of gallbladder adenocarcinoma at a tertiary institute were evaluated to establish two BN models using a tree-augmented naive Bayes algorithm. We then chose 250 patients with T3-4N0-2M0 stage gallbladder adenocarcinoma to test the posterior probability after the surgical type was taken into account. @@@ ResultsIn total, 170 patients (7 months) and 137 patients (>7 months) were correctly classified in the median survival time model (accuracy, 84.81%), and 204 patients (12 months), 15 patients (12-36 months), 17 patients (36-60 months), and 34 patients (>60 months) were correctly classified in the 1-, 3-, and 5-year survival model (accuracy, 74.59%), respectively. Every posterior probability in the two models upregulated the ratio of the longer survival time and suggested a better prognosis for gallbladder adenocarcinoma that can be improved by R0 resection. @@@ ConclusionsThese 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.

• 出版日期2017-12-15
• 单位西安交通大学; 西北工业大学