ArticleFrontiers in immunology2025
Predicting recurrence and recurrence-free survival in initially unresectable hepatocellular carcinoma: a novel nomogram for patients undergoing conversion hepatectomy with lenvatinib, PD-1 inhibitor, and interventional therapy.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Association between the Prognostic Nutritional Index and survival outcomes in hepatocellular carcinoma patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis.Translational cancer research · 2026Review
- A novel signature of palmitoylation for predicting prognosis and therapeutic response of hepatocellular carcinoma.Discover oncology · 2026Article
- Distinct roles of nutritional and inflammatory signatures in predicting pathological response versus long-term survival in locally advanced gastric cancer treated with neoadjuvant immunotherapy.Frontiers in oncology · 2026Article
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8 authors.
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Abstract
Purpose: This research aims to develop prognostic nomograms to predict tumor recurrence and recurrence-free survival (RFS) in individuals with initially unresectable hepatocellular carcinoma (uHCC) who were later subjected to conversion hepatectomy following lenvatinib, PD-1 inhibitors, and interventional (LPI) therapy. Methods: We performed a retrospective review of clinical information from 150 individuals diagnosed with HCC who underwent conversion hepatectomy following LPI therapy between November 2019 and December 2024. Independent predictors linked to recurrence and RFS were identified through comprehensive univariate and multivariate analyses, and the identified factors were subsequently integrated into nomogram models. Receiver operating characteristic (ROC) curves, calibration plots, and the concordance index (C-index) were employed to evaluate the predictive performance of the nomograms. Results: Our investigation identified several key risk factors for recurrence, including age, tumor number, tumor differentiation, preoperative prognostic nutritional index (PNI), preoperative systemic immune-inflammation index (SII), and postoperative protein induced by vitamin K absence or antagonist-II (PIVKA-II) level. For RFS, significant predictors included tumor number, tumor differentiation, preoperative SII, postoperative PIVKA-II, and postoperative alpha-fetoprotein (AFP) levels. The nomograms exhibited strong predictive performance, achieving a C-index of 0.837 (95% CI: 0.775-0.896) for recurrence prediction and 0.837 (95% CI: 0.788-0.886) for RFS. Our nomogram for recurrence prediction outperformed traditional staging systems like China Liver Cancer (CNLC) staging and Barcelona Clinic Liver Cancer (BCLC). Calibration curves and discriminative ability assessments confirmed the nomograms' reliability in predicting actual outcomes and stratifying patients into distinct prognostic subgroups with significant RFS differences across risk categories. Conclusions: The nomogram models established in this research provide an exceptionally accurate and individualized method for predicting recurrence and RFS in initially uHCC patients undergoing LPI-based conversion hepatectomy, potentially aiding clinicians in devising tailored treatment plans and enhancing patient outcomes.
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