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

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.