To investigate the influencing factors of recurrence in patients with gallbladder cancer after radical resection and to establish a Nomogram prediction model for the clinical prognosis.

118 patients with gallbladder cancer undergoing radical resection in the Second Affiliated Hospital of Nanchang University from March 1, 2011 to December 31, 2019 were recruited in this study. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 34 patients were male and 84 female, aged from 31 to 83 years, with a median age of 61 years. 78 cases recurred during the follow-up. The independent risk factors of recurrence were identified by Cox's proportional hazard regression model, and the Nomogram prediction model was established. The prediction value of this model was assessed by ROC, calibration curve and decision analysis curve.

Multivariate Cox's regression analysis showed that elevated CA19-9, T3-T4 stage and N1-N2 stage were the independent risk factors for the recurrence of gallbladder cancer after radical resection (HR=2.901, 21.462, 2.558; P<0.05). The C-index of Nomogram model based on the 3 risk factors was 0.828. The area under the ROC curve (AUC) of this model for predicting the 1-, 2- and 3-year recurrence-free survival of patients was 0.90, 0.97 and 0.99, indicating that the Nomogram model had high predictive value. The calibration curve showed a high consistency. Decision analysis curve revealed a high application value in clinical practice.

CA19-9, T stage and N stage are the influencing factors of postoperative recurrence of gallbladder cancer after radical resection. The Nomogram model based on these influencing factors yields high predictive value.