RAR-Based Prognostic Model for Predicting Overall Survival in Hepatitis B Virus-Related Hepatocellular Carcinoma: A Multicenter Study

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Purpose: Hepatitis B virus-related hepatocellular carcinoma poses a significant global health challenge. This study aimed to develop and validate a novel prognostic nomogram integrating the red blood cell distribution width-to-albumin ratio for predicting patients' overall survival. Patients and Methods: A retrospective cohort of 1403 patients was divided into training, internal validation, and external validation cohorts. A multivariate Cox regression model selected variables to construct a nomogram and an online calculator, which were subsequently validated. Results: The ratio emerged as an independent risk factor for long-term survival (hazard ratio: 5.808, 95% confidence interval: 1.721-19.599). A prognostic nomogram incorporating nine variables based on the ratio was developed. Calibration curves demonstrated high concordance between the predicted and actual 3-year survival rates. Decision curve analysis indicated that the nomogram significantly increased the net benefit of predicting 3-year survival. Based on the area under the receiver operating characteristic curves, the nomogram outperformed traditional models in predicting survival across the three cohorts. Patients were stratified into low-, intermediate-, and high-risk groups based on risk scores calculated from the nomogram. In all cohorts, the median survival time of the high-risk group was significantly shorter than that of the intermediate- and low-risk groups. An online calculator, deployed via a web-based platform, facilitated convenient mortality risk prediction for these patients. Conclusion: The ratio-based nomogram we developed can accurately predict the survival of patients with hepatitis B virus-related hepatocellular carcinoma, serving as an effective auxiliary tool for clinical personalized treatment and prognostic assessment.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.