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
PurposeThis 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 interventi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1602327/full |
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| author | Cheng Xu Zhihong Tang Meng Wei Danxi Liu Qingqing Pang Baishan Huang Xinglin Mo Feixiang Wu Feixiang Wu |
| author_facet | Cheng Xu Zhihong Tang Meng Wei Danxi Liu Qingqing Pang Baishan Huang Xinglin Mo Feixiang Wu Feixiang Wu |
| author_sort | Cheng Xu |
| collection | DOAJ |
| description | PurposeThis 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.MethodsWe 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.ResultsOur 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.ConclusionsThe 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. |
| format | Article |
| id | doaj-art-e53c7ee4b6434a04b638acadac180eeb |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-e53c7ee4b6434a04b638acadac180eeb2025-08-20T03:56:05ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16023271602327Predicting 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 therapyCheng Xu0Zhihong Tang1Meng Wei2Danxi Liu3Qingqing Pang4Baishan Huang5Xinglin Mo6Feixiang Wu7Feixiang Wu8Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, ChinaKey Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, ChinaPurposeThis 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.MethodsWe 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.ResultsOur 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.ConclusionsThe 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.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1602327/fullhepatocellular carcinomahepatectomyrecurrencerecurrence-free survivalnomogram model |
| spellingShingle | Cheng Xu Zhihong Tang Meng Wei Danxi Liu Qingqing Pang Baishan Huang Xinglin Mo Feixiang Wu Feixiang Wu 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 Frontiers in Immunology hepatocellular carcinoma hepatectomy recurrence recurrence-free survival nomogram model |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | hepatocellular carcinoma hepatectomy recurrence recurrence-free survival nomogram model |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1602327/full |
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