Prognostic utility of the serum uric acid-to-high-density lipoprotein cholesterol ratio following hepatectomy for hepatocellular carcinoma

ObjectiveTo evaluate the prognostic value of the uric acid-to-high-density lipoprotein cholesterol ratio in predicting postoperative survival in patients with hepatocellular carcinoma and to develop a nomogram to assist in clinical decision-making and patient management.MethodsA total of 422 patients who underwent hepatectomy at Meizhou People's Hospital between May 2011 and January 2023 were included. The optimal cutoff value for uric acid-to-high-density lipoprotein cholesterol ratio was determined using the R package 'survminer,' and patients were stratified into two groups accordingly. The prognostic significance of uric acid-to-high-density lipoprotein cholesterol ratio was evaluated using Kaplan-Meier survival analysis and Cox proportional hazards regression models. A prognostic nomogram was subsequently constructed. The predictive performance of the nomogram was assessed using the concordance index, and its clinical utility was evaluated via decision curve analysis.ResultsThe optimal cutoff value for uric acid-to-high-density lipoprotein cholesterol ratio was 253.9. Survival analysis demonstrated significantly longer survival in the low-uric acid-to-high-density lipoprotein cholesterol ratio group. Cox regression analysis identified uric acid-to-high-density lipoprotein cholesterol ratio, advanced lung cancer inflammation index, and tumor-node-metastasis classification stage as independent prognostic factors for postoperative survival in patients with hepatocellular carcinoma. A predictive nomogram incorporating these variables was developed and validated using calibration curves, time-dependent receiver operating characteristic analysis, and decision curve analysis. The results confirmed that the nomogram demonstrated superior predictive accuracy and greater net benefit compared with models based on any of the individual variables alone.ConclusionsUric acid-to-high-density lipoprotein cholesterol ratio may serve as a potential prognostic biomarker for postoperative survival in patients with hepatocellular carcinoma. The established nomogram may provide a practical tool for prognostic assessment in clinical practice.