Предоперационный индекс моноцитов к альбумину предсказывает выживаемость при раке печени

Preoperative monocyte-to-albumin ratio (MAR) independently predicted overall survival (OS) in patients with hepatocellular carcinoma (HCC) undergoing curative-intent hepatectomy, according to a study published in the World Journal of Surgical Oncology. Furthermore, incorporating MAR into a multivariable nomogram enhanced individualized prognostic accuracy beyond that of conventional staging. These findings support the use of a simple, low-cost biomarker reflecting systemic inflammation and nutritional status to refine perioperative risk stratification. In this retrospective cohort of 539 patients treated between May 2011 and July 2023, 474 (87.9%) were men and 65 (12.1%) were women, with a median age of 59 years (range, 23-85). Most patients had early-stage disease according to the American Joint Committee on Cancer (AJCC) 8th edition criteria (stage I-II; 74.77%). Median follow-up was 38.1 months (range, 3.1-144.9), and the median preoperative MAR was 123.84 (IQR, 89.99-169.70). An optimal cut-off of 145.7726 stratified patients into low-MAR (n=338) and high-MAR (n=201) groups. Survival analyses demonstrated inferior outcomes among patients with elevated MAR. Kaplan-Meier estimates showed significantly shorter OS in the high-MAR cohort compared with the low-MAR group (log-rank P <.001). In multivariable Cox modeling, lower MAR remained independently associated with improved OS after adjustment for clinicopathological factors (HR, 0.58; 95% CI, 0.42-0.82; P <.001). When treated as a continuous variable, MAR exhibited an approximately linear relationship with mortality risk, with each unit increase associated with a higher hazard (HR, 1.002; 95% CI, 1.000-1.004; P =.048), and no significant nonlinearity (P =.119). Additional independent prognostic variables included the AJCC TNM stage, tumor number, and the Advanced Lung Cancer Inflammation Index (ALI). Higher ALI correlated with improved survival (HR, 1.96; 95% CI, 1.37-2.81; P <.001). Stratified analyses confirmed the robustness of MAR, with low values consistently associated with longer OS across early-stage disease and high-ALI subgroups. Patients with combined low MAR and high ALI experienced the most favorable outcomes. A prognostic nomogram incorporating MAR, ALI, TNM stage, and tumor number estimated 1-, 3-, 5-, and 7-year OS with strong performance. Discrimination was high, with time-dependent areas under the curve of 0.78, 0.81, 0.79, and 0.73 for 1-year, 3-year, 5-year, and 7-year OS, respectively. Calibration plots demonstrated close agreement between predicted and observed survival, particularly at 1 and 3 years, and bootstrap validation (B=1000) indicated model stability. Decision curve analysis suggested meaningful clinical utility, with greater net benefit than treat-all or treat-none strategies across relevant thresholds. “The use of MAR in perioperative assessment could assist clinicians to identify persons at high risk, establish more aggressive follow-up plans, and streamline the postoperative care,” stated the authors. “Multi-center, prospective studies in the future are justified to confirm the best MAR cut-off, in addition, to understand the underlying biological processes and whether there are any dynamic variations in MAR, which are associated with treatment, that may be used as an indicator of response to treatment and monitoring of the disease.” This article originally appeared on Rare Disease Advisor References: Jiang X, Zhang LY, Liao JP, Tang X, Liu GM, Xu JW. Preoperative monocyte-to-albumin ratio predicts overall survival after hepatectomy for hepatocellular carcinoma: a single-center retrospective study. World J Surg Oncol. Published online June 6, 2026. doi:10.1186/s12957-026-04429-w