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

J Surg Oncol. 2017 Dec;116(8):1123-1131. doi: 10.1002/jso.24797. Epub 2017 Sep 6.

Abstract

Background and objectives: To determine whether radical resection can benefit patients with advanced gallbladder adenocarcinoma using a Bayesian network (BN) with clinical data.

Methods: In 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 naïve 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.

Results: In 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.

Conclusions: These 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.

Keywords: Bayesian network model; TNM stage; gallbladder adenocarcinoma; predictive model; surgery.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Aged
  • Bayes Theorem
  • Digestive System Surgical Procedures / methods*
  • Female
  • Gallbladder Neoplasms / mortality
  • Gallbladder Neoplasms / pathology
  • Gallbladder Neoplasms / surgery*
  • Humans
  • Male
  • Neoplasm Staging
  • Probability