Development and validation of a prognostic nomogram including inflammatory indicators for overall survival in hepatocellular carcinoma patients treated primarily with surgery or loco-regional therapy: A single-center retrospective study

Medicine (Baltimore). 2024 Dec 13;103(50):e40889. doi: 10.1097/MD.0000000000040889.

Abstract

Hepatocellular carcinoma (HCC) is among the most prevalent malignant tumors, but the current staging system has limited efficacy in predicting HCC prognosis. The authors sought to develop and validate a nomogram model for predicting overall survival (OS) in HCC patients primarily undergoing surgery or loco-regional therapy. Patients diagnosed with HCC from January 2017 to June 2023 were enrolled in the study. The data were randomly split into a training cohort and a validation cohort. Utilizing univariate and multivariate Cox regression analyses, independent risk factors for OS were identified, and a nomogram model was constructed to predict patient survival. Therapy, body mass index, portal vein tumor thrombus, leukocyte, γ-glutamyl transpeptidase to platelet ratio, monocyte to lymphocyte ratio, and prognostic nutritional index were used to build the nomogram for OS. The nomogram demonstrated strong predictive ability, with high C-index values (0.745 for the training cohort and 0.650 for the validation cohort). ROC curves, calibration plots, and DCA curves all indicated satisfactory performance of the nomogram. Kaplan-Meier curve analysis showed a significant difference in prognosis between patients in the low- and high- risk groups. This nomogram provides precise survival predictions for HCC patients and helps identify individuals with varying prognostic risks, emphasizing the need for individualized follow-up and treatment plans.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular* / blood
  • Carcinoma, Hepatocellular* / mortality
  • Carcinoma, Hepatocellular* / surgery
  • Carcinoma, Hepatocellular* / therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms* / blood
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / surgery
  • Liver Neoplasms* / therapy
  • Male
  • Middle Aged
  • Nomograms*
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Risk Factors