Xi Chengjun,Yang Chao.Prognostic value of fibrinogen-to-albumin ratio in children with neuroblastoma[J].Journal of Clinical Pediatric Surgery,,():323-332.[doi:10.3760/cma.j.cn101785-20260107-00009]
Prognostic value of fibrinogen-to-albumin ratio in children with neuroblastoma
- Keywords:
- Neuroblastoma; Fibrinogen-to-albumin Ratio; Nomograms; Prognosis; Overall Survival; Child
- Abstract:
- Objective To explore the prognostic value of preoperative fibrinogen-to-albumin ratio (FAR) in children with neuroblastoma (NB).Methods Between January 2014 and January 2025,retrospective analysis was conducted for the relevant clinical data of 279 NB children.They were randomized into two cohorts of training (n=195) and validation (n=84).The optimal cutoff value for FAR was determined by receiver operating characteristic (ROC) curve analysis.Univariate and multivariate Cox proportional hazards regression models were utilized for identifying independent prognostic factors and subsequently used for constructing a nomogram.The predictive performance of the model was evaluated via concordance index (C-index),time-dependent ROC curve,calibration curve and decision curve analysis (DCA).Results The optimal cutoff value of FAR for prognostic prediction was 0.0734.Multivariate Cox regression analysis revealed that age ≥18 month,MYCN amplification,INRG stage M and a high FAR were independent risk factors for OS in NB children.The areas under the curve (AUCs) of nomogram for predicting 3/5-year OS were 0.812 and 0.869 in training cohort and 0.824 and 0.846 in validation cohort.Calibration curve demonstrated strong consistency between predicted and observed survival probabilities,and DCA confirmed the model’s substantial clinical net benefit.Furthermore,risk stratification based upon the nomogram scores successfully discriminated children with different survival outcomes (P<0.001).Conclusions Preoperative FAR serves as an independent prognostic predictor for NB children.And FAR-incorporated nomogram exhibits excellent discrimination,calibration and clinical utility,facilitating individualized prognostic assessments for NB children.
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Memo
收稿日期:2026-1-7。
通讯作者:杨超,Email:400843@hospital.cqmu.edu.cn