Evidence mapPaperPMID 40657164Full record

ArticleSurgery open science2025

Comparison of machine learning and Cox regression models for prognostic analysis in hepatocellular carcinoma patients with distant metastasis.

Hailan Li, Junbo Wang, Xin Ming, Mingsha Zhou, Li Zhou

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In one paragraph

Article in Surgery open science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Hailan LiDepartment of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.
Junbo WangDepartment of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.
Xin MingDepartment of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.
Mingsha ZhouDepartment of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.
Li ZhouDepartment of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: With the development of conversion therapy, there has been a significant improvement in advanced stage hepatocellular carcinoma (HCC) patients' survival outcomes. Accurate prognostic assessment of patients with distant metastasis (DM) is therefore pivotal in improving quality of life, guiding treatment, and optimizing patient management. Methods: This study extracted patients with distant metastatic HCC from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression were used to identify prognostic factors. Then, Cox regression, DeepSurv, Decision Tree, and Random Survival Forests models were used to predict overall survival. Model performance was evaluated by area under the curve (AUC), decision curve analysis, calibration curve, and Brier score. The visualization of Cox regression and machine learning algorithms utilized nomogram and Shapley additive explanations, respectively. Results: The study included 3051 HCC patients with DM. Factors such as tumor size, lung metastasis, N stage, ace, chemotherapy, radiotherapy, AFP, fibrosis, treatment interval, and number of metastases were independently associated with patient prognosis. Among all models, Cox regression and Random Survival Forest models showed stable performance, achieving AUCs of 0.746/0.760, 0.745/0.749, and 0.729/0.718 at 3, 6, and 12 months, respectively. Meanwhile, Cox regression showed the lowest Brier score (0.180 and 0.125) at 6 and 12 months. Conclusions: Cox regression and Random Survival Forest models demonstrated robust prognostic performance for HCC, with Cox regression exhibiting superior temporal stability. The Cox-based nomogram provides an intuitive tool for rapid 3-, 6-, and 12-month survival stratification in metastatic HCC patients.

Indexed as

Distant metastasisHepatocellular carcinomaMachine learningNomogram

Identifiers

PMID40657164
PMCPMC12246928

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.