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. 2025 Sep;14(18):e71203.
doi: 10.1002/cam4.71203.

Individualized Prognostic Insights: CONUT-GBRS for Survival Prediction in Gallbladder Cancer

Si-Qi Yang  1 , Rui-Qi Zou  1 , Yu-Shi Dai  1 , Jun-Ke Wang  1 , Wen-Jie Ma  1 , Hai-Jie Hu  1 , Fu-Yu Li  1
Affiliations

Individualized Prognostic Insights: CONUT-GBRS for Survival Prediction in Gallbladder Cancer

Si-Qi Yang et al. Cancer Med. 2025 Sep.

Abstract

Background: The most suitable prognostic prediction system for gallbladder cancer (GBC) is yet to be determined. This study aims to establish a combined score integrating preoperative patients' nutritional and immune status and pathological parameters to forecast the survival outcomes following curative-intent surgery of GBC.

Methods: This retrospective study included patients diagnosed with GBC based on postoperative pathological examinations. The patients underwent curative surgery at West China Hospital of Sichuan University (China) between January 2014 and December 2022. Using the controlling nutritional status (CONUT) score and gallbladder cancer predictive risk score (GBRS), we generated the CONUT-GBRS for every patient, and the patients were divided into two groups based on the optimal cutoff value. Comparisons were made between the two groups regarding clinicopathologic features and survival.

Results: The optimal cutoff value for the CONUT-GBRS was 1.39. There were 99 and 201 individuals in the high and low CONUT-GBRS groups, respectively. Patients with high CONUT-GBRS experienced poorer overall survival and disease-free survival compared with those with low CONUT-GBRS, even after propensity score matching analysis. Both univariate and multivariate Cox analyses established that CONUT-GBRS stood as an independent prognostic factor for GBC patients. Subgroup analysis indicated that CONUT-GBRS was also an effective predictor of prognosis in patients with incidental GBC.

Conclusion: The CONUT-GBRS serves as an advantageous, straightforward, and cost-effective prognostic tool for GBC, offering valuable prognostic insights and guiding the tailoring of individualized treatment strategies to improve patient outcomes.

Keywords: controlling nutritional status (CONUT) score; gallbladder cancer; gallbladder cancer predictive risk score (GBRS); prognosis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Comparison of survival outcomes between low and high CONUT‐GBRS groups. (a) Overall survival of GBC before PSM. (b) Disease‐free survival of GBC before PSM. (c) Overall survival of IGBC. (d) Disease‐free survival of ICGB. (e) Overall survival after PSM. (f) Disease‐free survival after PSM.
FIGURE 2
FIGURE 2
Comparison of survival outcomes of GBC patients stratified based on the CONUT score and GBRS. Overall survival (a) and disease‐free survival (b) of GBC stratified based on the CONUT score; overall survival (c) and disease‐free survival (d) of ICGB stratified based on the CONUT score; overall survival (e) and disease‐free survival (f) of GBC stratified based on the GBRS; overall survival (g) and disease‐free survival (h) of ICGB stratified based on the GBRS.
FIGURE 3
FIGURE 3
Cox regression analysis for overall survival and disease‐free survival. (a) Univariate analysis for overall survival. (b) Multivariate analysis for overall survival. (c) Univariate analysis for disease‐free survival. (d) Multivariate analysis for disease‐free survival.
See this image and copyright information in PMC

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