A prognostic model for gallbladder cancer can refine adjuvant chemotherapy decisions and improve patient outcomes.

• In a study of 2,252 patients, age, tumor grade, N stage, tumor size, and sex predicted overall survival more accurately than the TNM system.
• The 5-year overall survival rate was only 27.3%.

High-risk patients saw improved survival with adjuvant chemotherapy, while it was detrimental for low-risk and had minimal effect on intermediate-risk groups.

• Individualized treatment strategies can optimize outcomes and avoid unnecessary treatments for low-risk patients.