Construction and validation of a prognostic prediction model for hepatectomy of hepatocellular carcinoma by preoperative fibrinogen to prealbumin ratio（FPR）

Abstract Purpose To enhance the prognostic prediction of patients following hepatectomy, our study aimed to investigate potential predictors of postoperative prognosis in hepatocellular carcinoma (HCC) patients and develop a nomogram model capable of effectively predicting their postoperative prognosis Methods Data from 1056 HCC patients who underwent hepatectomy from January 2014 to 2018 in December were retrospectively studied. The preoperative fibrinogen and prealbumin results were collected from all patients, and the preoperative fibrinogen to prealbumin ratio(FPR)was calculated. The optimal cutoff value method was used to differentiate between the high and low FPR groups, and the nomogram prognostic model of the patients was constructed by combining with the results of the postoperative pathology examination and other results. Results According to the best cut-off value, the FPR groups were divided into high and low FPR groups with a cut-off value of 0.019, and the high FPR group was associated with poor prognosis of the patients. Barcelona (BCLC) stage, microvascular invasion (MVI), and pathologic grade were independent predictors after hepatectomy in patients with HCC. Combining FPR and, these factor variables to create a prognostic nomogram, the model was confirmed to have a good fit while showing good performance with C-indexes of 0.736 and 0.754 for the training and validation sets, respectively. Conclusion A novel and validated nomogram was constructed by FPR combined with tumor staging and postoperative pathology results for predicting the prognosis of HCC patients after hepatectomy.