当前肝细胞癌（HCC）的分期系统在临床实践中仍存在局限性。我们的研究旨在探讨预后因素，并建立一种新的预后模型，用于预测HCC患者的癌特异性生存（CSS）情况。我们从Surveillance, Epidemiology, and End Results（SEER）数据库中筛选了6,166名HCC患者。将患者随机分为训练组（70%）和验证组（30%）。采用多变量Cox分析确定患者CSS的预后因素，然后将这些变量纳入模型，建立了一个新的预测癌特异性生存2年和5年的预后模型。对该预后模型的性能进行了定标、一致性指数（C-指数）、受试者工作特征（ROC）曲线下面积（AUC）和决策曲线分析（DCA）的评估。多变量Cox分析发现，美国癌症联合委员会（AJCC）分期、种族、分级、手术、化疗、放疗、肿瘤大小、骨转移（BM）和甲胎蛋白（AFP）与CSS独立相关。包含这些预测因素的预测模型表现良好，在训练组C-指数为0.802（95%置信区间为0.792-0.812），在验证组C-指数为0.801（95%置信区间为0.787-0.815）。定标曲线显示实际观察结果与预测结果之间有良好的一致性。此外，与第7版肿瘤-淋巴结-转移（TNM）分期系统（AUC为0.735和0.717）相比，该预测模型显示出更好的判别能力（验证集中2年和5年CSS的AUC为0.873和0.875）。DCA也显示了该预测模型的良好应用性。该研究提出了一种新的预后模型，该模型融合了HCC的重要预后因素，可方便地准确预测HCC患者的2年和5年CSS，从而有助于个体化临床决策。2023 Journal of Gastrointestinal Oncology. All rights reserved.

Current staging systems for hepatocellular carcinoma (HCC) still have limitations in clinical practice. Our study aimed to explore the prognostic factors and develop a new nomogram to predict the cancer-specific survival (CSS) for patients with HCC.A total of 6,166 HCC patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly grouped into the training cohort (70%) and validation cohort (30%). Multivariate Cox analysis was used to identify prognostics factors for CSS of patients, then we incorporated these variables and presented a new nomogram to predict 2- and 5-year CSS. The performance of the nomogram was assessed with respect to its calibration, concordance index (C-index), area under the receiver operating characteristic (ROC) curve (AUC), and decision curve analysis (DCA).Multivariate Cox analysis revealed that American Joint Committee on Cancer (AJCC) stage, race, grade, surgery, chemotherapy, radiation, tumor size, bone metastasis (BM), and alpha-fetoprotein (AFP) were independently associated with CSS. The prediction nomogram which contained these predictors showed good performance, with a C-index of 0.802 [95% confidence interval (CI), 0.792-0.812] in the training cohort and 0.801 (95% CI, 0.787-0.815) in the validation cohort. The calibration curves demonstrated good agreement between the actual observation and the nomogram prediction. Furthermore, the nomogram showed improved discriminative capacity (AUC, 0.873 and 0.875 for 2- and 5-year CSS in validation set) compared to the 7th tumor-node-metastasis (TNM) staging system (AUC, 0.735 and 0.717). The DCA also indicated good application of the nomogram.This study presents a novel nomogram that incorporates the important prognostic factors of HCC, which can be conveniently used to accurately predict the 2- and 5-year CSS of patients with HCC, thus assisting individualized clinical decision making.2023 Journal of Gastrointestinal Oncology. All rights reserved.