Establishment and validation of a novel prognostic model for non-virus-related hepatocellular carcinoma

Abstract

Objective The incidence of non-virus-related hepatocellular carcinoma (NV-HCC) in hepatocellular carcinoma (HCC) is steadily increasing. The aim of this study is to establish a prognostic model to evaluate the overall survival (OS) of NV-HCC. Methods Overall, 261 patients with NV-HCC were enrolled in this study. A prognostic model was developed by using LASSO-Cox regression analysis. The prognostic power was appraised by the concordance index (C-index), and the time-dependent receiver operating characteristic curve (TD-ROC). The Kaplan-Meier (K-M) survival analysis was used to evaluate the predictive ability in respective subgroups stratified by prognostic model risk score. A nomogram for survival prediction was established by integrating prognostic model, TNM stage, and treatment. Results According to the LASSO-Cox regression result, number of nodules, lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index (PNI), alkaline phosphatase (ALP), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (SLR) and C-reactive protein (CRP) were included for prognostic model construction. The C-index of the prognostic model was 0.761(95%CI: 0.723 ~ 0.799) in the development and 0.795 (95%CI: 0.735 ~ 0.855) in the validation cohort, and its predictive ability better than TNM stage and treatment, the TD-ROC showed similar results. K-M survival analysis showed that NV-HCC patients with low-risk score had a better prognosis (P < 0.05). A nomogram based on prognostic model, TNM stage, and treatment was constructed with sufficient discriminatory power with C-index of 0.78 and 0.85 in the development and validation cohort, respectively. Conclusion For NV-HCC, the prognostic model could predict OS benefit for patients, which may be helpful to clinicians to give individualized therapeutic suggestions.