ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1633488
This article is part of the Research TopicIntrahepatic Cholangiocarcinoma: Emerging Insights from Pathobiology to Clinical Translation – Innovative Strategies, Challenges, and OpportunitiesView all 11 articles
The prognostic value of the preoperative albumin-to-fibrinogen ratio in patients with intrahepatic cholangiocarcinoma: A multicenter retrospective propensity score matching analysis
Provisionally accepted- 1Shandong University, Jinan, China
- 2Shandong Provincial Hospital, Jinan, China
- 3West China Hospital, Chengdu, Sichua, China
- 4First Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China
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Background: This study evaluated the prognostic role of the albumin-to-fibrinogen ratio (AFR) in patients with intrahepatic cholangiocarcinoma (ICC) after curative liver resection. Methods: Retrospectively analyzed the clinicopathological information of ICC patients and stratified them into two groups by AFR (8.71). A 1:3 propensity score matching (PSM) analysis was used to eliminate possible biases. Kaplan-Meier method was used for survival analysis. Independent prognostic factors for overall survival (OS) and disease-free survival (DFS) were analyzed using Cox regression analysis, and based on which two nomograms were constructed. The concordance index (C-index), decision curve analysis (DCA), calibration curve, and receiver operating characteristic (ROC) curve were used to validate the nomograms. Results: 559 patients were included and were divided into low-and high-AFR groups, respectively. High-AFR group had better prognosis. The multivariate analysis revealed that AFR was an independent prognostic factor for both OS (hazard ratio [HR] 0.393, P < 0.001) and DFS (HR 0.538, P < 0.001). Two nomograms were established to predict OS and DFS, and demonstrated high predictive accuracy and clinical utility. Furthermore, ROC curves demonstrated the high predictive power of the nomogram for survival in ICC patients. Conclusions: Preoperative AFR was an independent prognostic factor for postoperative OS and DFS in ICC patients, and AFR-based nomograms effectively predict postoperative survival outcomes.
Keywords: intrahepatic cholangiocarcinoma, Albumin-to-fibrinogen ratio, prognosis, Propensity score matching, nomogram
Received: 22 May 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Yang, Kong, Wang, Ji, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Guangbing Li, lgb002@126.com
Jun Liu, dr_liujun1967@126.com
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