Tan JY, Yang JX, Xu QJ, Zhao YL, Zhang W, Li XS. Prognostic nomogram model for overall survival in patients with hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(7): 120724 [DOI: 10.4251/wjgo.v18.i7.120724]
Corresponding Author of This Article
Xiao-Sheng Li, PhD, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. toxiaosheng@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
research-article
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Tan JY, Yang JX, Xu QJ, Zhao YL, Zhang W, Li XS. Prognostic nomogram model for overall survival in patients with hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(7): 120724 [DOI: 10.4251/wjgo.v18.i7.120724]
Jing-Yu Tan, Jing-Xian Yang, Yu-Lan Zhao, Wei Zhang, Xiao-Sheng Li, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
Qian-Jie Xu, Chongqing Cancer Multi-Omics Big Data Application Engineering Research Center, Chongqing University Cancer Hospital, Chongqing 400030, China
Co-first authors: Jing-Yu Tan and Jing-Xian Yang.
Co-corresponding authors: Wei Zhang and Xiao-Sheng Li.
Author contributions: Tan JY and Yang JX drafted the manuscript as co-first authors; Yang JX and Xu QJ performed the data collection and cleaning; Xu QJ performed statistical analysis and interpretation; Zhao YL and Zhang W designed and substantively revised the article; Zhang W and Li XS conceived and designed the study as co-corresponding authors; all authors contributed to the article and approved the final manuscript.
Institutional review board statement: In our research, we adhered to the ethical principles outlined in the Declaration of Helsinki regarding the use of human subjects in medical research. Chongqing University Cancer Hospital’s Ethics Committee reviewed and approved research studies (No. CZLS2023343-A).
Clinical trial registration statement: Considering that our study does not involve any intervention in patient treatment, according to our institution’s requirements at the time, we only needed to obtain ethical approval, and therefore did not register this clinical study.
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: All supporting data can be obtained from the corresponding author upon reasonable request.
Corresponding author: Xiao-Sheng Li, PhD, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. toxiaosheng@163.com
Received: March 9, 2026 Revised: March 19, 2026 Accepted: April 27, 2026 Published online: July 15, 2026 Processing time: 123 Days and 9.9 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) poses a significant health challenge in China because of its high incidence and mortality rate.
AIM
To determine the prognostic factors for HCC patients in southwestern China and develop a novel model to predict overall survival.
METHODS
A total of 958 primary HCC patients were included in this study. Multivariate Cox regression analysis revealed independent prognostic factors, which were subsequently used to construct a nomogram. The performance of the nomogram was evaluated using the concordance index (C-index), area under the receiver operating characteristic curve, time-dependent C-index and area under the receiver operating characteristic curve, calibration curves, and decision curve analysis.
RESULTS
Multivariate Cox regression revealed the following independent prognostic factors: (1) Karnofsky performance status; (2) Sex; (3) Diabetes status; (4) Tumor node metastasis stage; (5) Chemotherapy, surgery; (6) Fibrinogen degradation products; (7) β2-microglobulin level; (8) Albumin; and (9) Neutrophil-to-lymphocyte ratio. For the training set, the C-index was 0.752 (95%CI: 0.731-0.774), whereas for the validation set, it was 0.716 (95%CI: 0.680-0.752). The calibration curves for both the training set and the validation set revealed a high level of consistency between the observed values and the model-predicted survival probabilities. Decision curve analysis validated the potential clinical utility of the model.
CONCLUSION
This study developed a novel prognostic model for predicting overall survival in HCC patients, providing a valuable tool to support clinical decision-making and optimize patient management.
Core Tip: A novel prognostic nomogram for overall survival was developed in this study of 958 Chinese patients with hepatocellular carcinoma, using routine clinical variables. This study revealed that Karnofsky performance status, sex, diabetes status, tumor node metastasis stage, treatment, fibrinogen degradation products, β2-microglobulin, albumin, and neutrophil-to-lymphocyte ratio play significant roles in predicting patient outcomes. The model demonstrated excellent predictive accuracy (concordance index of 0.752) and clinical utility, offering a practical tool to improve personalized risk assessment and management of patients with hepatocellular carcinoma in Southwest China.
