Prognostic Value of Preoperative Neutrophil Percentage to Albumin Ratio in Patients with Hepatocellular Carcinoma

Objectives: To investigate the predictive value of the peripheral blood neutrophil percentage and serum albumin ratio (NPAR) for overall survival after radical resection of hepatocellular carcinoma, and to construct a nomogram prediction model. Methods: A retrospective cohort study was performed, including patients who underwent radical resection of hepatocellular carcinoma at the Second Hospital of Lanzhou University from 2013 to 2023. The optimal cut-off value of the NPAR was determined by a ROC curve. Kaplan–Meier and log-rank tests were used for grouping. Cox regression was used to analyze prognostic factors and construct a nomogram. Results: A total of 207 patients were included in this study. ROC curve analysis was conducted using preoperative NPAR values, and the results showed an area under the curve (AUC) of 0.72, the optimal cut-off value of the NPAR was 14.83, and the high NPAR (≥14.83) group had better overall survival and disease-free survival. Multivariable analysis showed that an NPAR ≥ 14.83, tumor diameter > 5 cm, multiple tumors, and low tumor differentiation were independent risk factors for overall survival. The C-index of the nomogram for overall survival (OS) was 0.77, indicating a moderate but clinically acceptable discriminative ability for predicting overall survival. Conclusions: Preoperative NPAR is an effective prognostic marker, and the established nomogram can accurately predict the overall survival of patients.