Nomogram integrating prognostic immune-inflammatory-nutritional score with clinicopathological parameters for predicting post-transplantation outcomes in hepatocellular carcinoma

Figure 1 Kaplan-Meier curves for overall survival categorized by immune, inflammatory, and nutritional indexes. A: Kaplan-Meier curves of overall survival (OS) stratified by albumin-bilirubin grade; B: Kaplan-Meier curves of OS stratified by prognostic nutritional index; C: Kaplan-Meier curves of OS stratified by lymphocyte-to-monocyte ratio; D: Kaplan-Meier curves of OS stratified by systemic immune-inflammation index; E: Kaplan-Meier curves of OS stratified by neutrophil-to-lymphocyte ratio; F: Kaplan-Meier curves of OS stratified by platelet-to-lymphocyte ratio; G: Kaplan-Meier curves of OS stratified by systemic inflammation response index. ALBI: Albumin-bilirubin index; PNI: Prognostic nutritional index; LMR: Lymphocyte-to-monocyte ratio; SII: Systemic immune-inflammation index; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; SIRI: Systemic inflammation response index.

Figure 2 Kaplan-Meier curves for disease-free survival categorized by immune, inflammatory, and nutritional indexes. A: Kaplan-Meier curves of disease-free survival (DFS) stratified by albumin-bilirubin grade; B: Kaplan-Meier curves of DFS stratified by prognostic nutritional index; C: Kaplan-Meier curves of DFS stratified by lymphocyte-to-monocyte ratio; D: Kaplan-Meier curves of DFS stratified by systemic immune-inflammation index; E: Kaplan-Meier curves of DFS stratified by neutrophil-to-lymphocyte ratio; F: Kaplan-Meier curves of DFS stratified by platelet-to-lymphocyte ratio; G: Kaplan-Meier curves of DFS stratified by systemic inflammation response index. ALBI: Albumin-bilirubin index; PNI: Prognostic nutritional index; LMR: Lymphocyte-to-monocyte ratio; SII: Systemic immune-inflammation index; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; SIRI: Systemic inflammation response index.

Figure 3 Development of the prognostic immune-inflammatory-nutritional score using a least absolute shrinkage and selection operator regression model. A: Heatmap of pairwise connections across indicators related to immunity, inflammation, and nutrition; B: Coefficient path plot for seven candidate variables in least absolute shrinkage and selection operator regression; C: Cross-validation curve of least absolute shrinkage and selection operator regression; D: Receiver characteristic curves of prognostic immune-inflammatory-nutritional score in predicting postoperative 1-year, 3-year, and 5-year overall survival in the training set; E: Receiver characteristic curves of prognostic immune-inflammatory-nutritional score in predicting postoperative 1-year, 3-year, and 5-year overall survival in the validation sets. LMR: Lymphocyte-to-monocyte ratio; PNI: Prognostic nutritional index; PLR: Platelet-to-lymphocyte ratio; SII: Systemic immune-inflammation index; ALBI: Albumin-bilirubin index; NLR: Neutrophil-to-lymphocyte ratio; SIRI: Systemic inflammation response index; AUC: Area under the receiver characteristic curve.

Figure 4 Prognostic significance of the prognostic immune-inflammatory-nutritional score. A: Kaplan-Meier curve of overall survival (OS) in the training set stratified by prognostic immune-inflammatory-nutritional (PIIN) score; B: Kaplan-Meier curve of disease-free survival (DFS) in the training set stratified by PIIN score; C: Kaplan-Meier curve of OS in the validation set stratified by PIIN score; D: Kaplan-Meier curve of DFS in the validation set stratified by PIIN score; E: Forest plot of the multivariable Cox regression for OS in the training set; F: Forest plot of the multivariable Cox regression for DFS in the training set; G: Forest plot of the multivariable Cox regression for OS in the validation set; H: Forest plot of the multivariable Cox regression for DFS in the validation set. PIIN: Prognostic immune-inflammatory-nutritional; AFP: Alpha fetoprotein; MVI: Microvascular invasion; HR: Hazard ratio; CI: Confidence interval.

Figure 5 Development and validation of the prognostic immune-inflammatory-nutritional score-based nomograms. A: Nomogram incorporating the prognostic immune-inflammatory-nutritional (PIIN) score and clinicopathological variables to predict overall survival (OS) in the training set; B: Nomogram incorporating the PIIN score and clinicopathological variables to predict disease-free survival (DFS) in the training set; C: Receiver operating characteristic curves (ROC) of the PIIN-based nomogram in predicting postoperative 1-year, 3-year, and 5-year OS in the training set; D: ROC of the PIIN-based nomogram in predicting postoperative 1-year, 3-year, and 5-year DFS in the training set; E: ROC of the PIIN-based nomogram in predicting postoperative 1-year, 3-year, and 5-year OS in the validation set; F: ROC of the PIIN-based nomogram in predicting postoperative 1-year, 3-year, and 5-year DFS in the validation set. AFP: Alpha fetoprotein; PIIN: Prognostic immune-inflammatory-nutritional; OS: Overall survival; DFS: Disease-free survival; AUC: Area under the receiver characteristic curve.

Figure 6 Calibration of the prognostic immune-inflammatory-nutritional score-based nomograms for overall survival and disease-free survival. A: Calibration curve of predicted and observed 1-year overall survival (OS) probabilities in the training cohort; B: Calibration curve of predicted and observed 3-year OS probabilities in the training cohort; C: Calibration curve of predicted and observed 5-year OS probabilities in the training cohort; D: Calibration curve of predicted and observed 1-year disease-free survival (DFS) probabilities in the training cohort; E: Calibration curve of predicted and observed 3-year DFS probabilities in the training cohort; F: Calibration curve of predicted and observed 5-year DFS probabilities in the training cohort; G: Calibration curve of predicted and observed 1-year OS probabilities in the validation cohort; H: Calibration curve of predicted and observed 3-year OS probabilities in the validation cohort; I: Calibration curve of predicted and observed 5-year OS probabilities in the validation cohort; J: Calibration curve of predicted and observed 1-year DFS probabilities in the validation cohort; K: Calibration curve of predicted and observed 3-year DFS probabilities in the validation cohort; L: Calibration curve of predicted and observed 5-year DFS probabilities in the validation cohort. OS: Overall survival; DFS: Disease-free survival.

Figure 7 Decision curve analysis of the prognostic immune-inflammatory-nutritional score based on prediction models for overall survival and disease-free survival. A: Comparison of decision curve analysis (DCA) curve of prognostic immune-inflammatory-nutritional (PIIN)-based prediction model, Milan criteria and University of California, San Francisco (UCSF) criteria for 1-year overall survival (OS) in the training set; B: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and University of UCSF criteria for 3-year OS in the training set; C: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and UCSF criteria for 5-year OS in the training set; D: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and Risk Estimation of Tumor Recurrence After Transplant (RETREAT) score for 1-year disease-free survival (DFS) in the training set; E: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and RETREAT score for 3-year DFS in the training set; F: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and RETREAT score for 5-year DFS in the training set; G: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and UCSF criteria for 1-year OS in the validation set; H: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and University of UCSF criteria for 3-year OS in the validation set; I: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and UCSF criteria for 5-year OS in the validation set; J: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and RETREAT score for 1-year DFS in the validation set; K: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and RETREAT score for 3-year DFS in the validation set; L: Comparison of DCA curve of PIIN-based prediction model, Milan criteria and RETREAT score for 5-year DFS in the validation set. UCSF: University of California, San Francisco; RETREAT: Risk Estimation of Tumor Recurrence After Transplant.