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Development and internal validation of a multifactorial risk prediction model for gallbladder cancer in a high-incidence country.
Boekstegers, Felix; Scherer, Dominique; Barahona Ponce, Carol; Marcelain, Katherine; Gárate-Calderón, Valentina; Waldenberger, Melanie; Morales, Erik; Rojas, Armando; Munoz, César; Retamales, Javier; de Toro, Gonzalo; Barajas, Olga; Rivera, María Teresa; Cortés, Analía; Loader, Denisse; Saavedra, Javiera; Gutiérrez, Lorena; Ortega, Alejandro; Bertrán, Maria Enriqueta; Bartolotti, Leonardo; Gabler, Fernando; Campos, Mónica; Alvarado, Juan; Moisán, Fabricio; Spencer, Loreto; Nervi, Bruno; Carvajal-Hausdorf, Daniel; Losada, Héctor; Almau, Mauricio; Fernández, Plinio; Olloquequi, Jordi; Fuentes-Guajardo, Macarena; Gonzalez-Jose, Rolando; Bortolini, Maria Cátira; Acuña-Alonzo, Victor; Gallo, Carla; Linares, Andres Ruiz; Rothhammer, Francisco; Lorenzo Bermejo, Justo.
Affiliation
  • Boekstegers F; Statistical Genetics Research Group, Institute of Medical Biometry, Heidelberg University, Heidelberg, Germany.
  • Scherer D; Statistical Genetics Research Group, Institute of Medical Biometry, Heidelberg University, Heidelberg, Germany.
  • Barahona Ponce C; Statistical Genetics Research Group, Institute of Medical Biometry, Heidelberg University, Heidelberg, Germany.
  • Marcelain K; Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago, Chile.
  • Gárate-Calderón V; Statistical Genetics Research Group, Institute of Medical Biometry, Heidelberg University, Heidelberg, Germany.
  • Waldenberger M; Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago, Chile.
  • Morales E; Research Unit of Molecular Epidemiology and Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
  • Rojas A; Hospital Regional de Talca, Talca, Chile.
  • Munoz C; Facultad de Medicina, Universidad Católica del Maule, Talca, Chile.
  • Retamales J; Facultad de Medicina, Universidad Católica del Maule, Talca, Chile.
  • de Toro G; Hospital Regional de Talca, Talca, Chile.
  • Barajas O; Facultad de Medicina, Universidad Católica del Maule, Talca, Chile.
  • Rivera MT; Instituto Nacional del Cáncer, Santiago, Chile.
  • Cortés A; Hospital de Puerto Montt, Puerto Montt, Chile.
  • Loader D; Escuela de Tecnología Médica, Universidad Austral de Chile sede Puerto Montt, Puerto Montt, Chile.
  • Saavedra J; Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago, Chile.
  • Gutiérrez L; Hospital Clínico Universidad de Chile, Santiago, Chile.
  • Ortega A; Hospital del Salvador, Santiago, Chile.
  • Bertrán ME; Hospital del Salvador, Santiago, Chile.
  • Bartolotti L; Hospital Padre Hurtado, Santiago, Chile.
  • Gabler F; Hospital Padre Hurtado, Santiago, Chile.
  • Campos M; Hospital San Juan de Dios, Santiago, Chile.
  • Alvarado J; Hospital Regional, Arica, Chile.
  • Moisán F; Unidad Registro Hospitalario de Cáncer, Hospital Base de Valdivia, Valdivia, Chile.
  • Spencer L; Hospital Base de Valdivia, Chile.
  • Nervi B; Hospital San Borja Arriarán, Santiago, Chile.
  • Carvajal-Hausdorf D; Hospital San Borja Arriarán, Santiago, Chile.
  • Losada H; Hospital Regional Guillermo Grant Benavente, Concepción, Chile.
  • Almau M; Hospital Regional Guillermo Grant Benavente, Concepción, Chile.
  • Fernández P; Hospital Regional Guillermo Grant Benavente, Concepción, Chile.
  • Olloquequi J; Departamento de Hematología y Oncología, Escuela de Medicina Pontificia Universidad Católica de Chile, Santiago, Chile.
  • Fuentes-Guajardo M; Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
  • Gonzalez-Jose R; Departamento de Cirugía, Universidad de La Frontera, Temuco, Chile.
  • Bortolini MC; Hospital de Rancagua, Rancagua, Chile.
  • Acuña-Alonzo V; Hospital de Rancagua, Rancagua, Chile.
  • Gallo C; Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain.
  • Linares AR; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile.
  • Rothhammer F; Departamento de Tecnología Médica, Facultad de Ciencias de la Salud, Tarapacá University, Arica, Chile.
  • Lorenzo Bermejo J; Instituto Patagónico de Ciencias Sociales y Humanas, Centro Nacional Patagónico, CONICET, Puerto Madryn, Argentina.
Int J Cancer ; 153(6): 1151-1161, 2023 09 15.
Article in En | MEDLINE | ID: mdl-37260300
Since 2006, Chile has been implementing a gallbladder cancer (GBC) prevention program based on prophylactic cholecystectomy for gallstone patients aged 35 to 49 years. The effectiveness of this prevention program has not yet been comprehensively evaluated. We conducted a retrospective study of 473 Chilean GBC patients and 2137 population-based controls to develop and internally validate three GBC risk prediction models. The Baseline Model accounted for gallstones while adjusting for sex and birth year. Enhanced Model I also included the non-genetic risk factors: body mass index, educational level, Mapuche surnames, number of children and family history of GBC. Enhanced Model II further included Mapuche ancestry and the genotype for rs17209837. Multiple Cox regression was applied to assess the predictive performance, quantified by the area under the precision-recall curve (AUC-PRC) and the number of cholecystectomies needed (NCN) to prevent one case of GBC at age 70 years. The AUC-PRC for the Baseline Model (0.44%, 95%CI 0.42-0.46) increased by 0.22 (95%CI 0.15-0.29) when non-genetic factors were included, and by 0.25 (95%CI 0.20-0.30) when incorporating non-genetic and genetic factors. The overall NCN for Chileans with gallstones (115, 95%CI 104-131) decreased to 92 (95%CI 60-128) for Chileans with a higher risk than the median according to Enhanced Model I, and to 80 (95%CI 59-110) according to Enhanced Model II. In conclusion, age, sex and gallstones are strong risk factors for GBC, but consideration of other non-genetic factors and individual genotype data improves risk prediction and may optimize allocation of financial resources and surgical capacity.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Gallstones / Gallbladder Neoplasms Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Int J Cancer Year: 2023 Document type: Article Affiliation country: Germany Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Gallstones / Gallbladder Neoplasms Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Int J Cancer Year: 2023 Document type: Article Affiliation country: Germany Country of publication: United States