Objective:

To develop and validate a nomogram model for predicting overall survival (OS) in hepatocellular carcinoma (HCC) patients treated with high-intensity focused ultrasound (HIFU).

Key Findings:

• 15 factors significantly associated with OS were identified through univariate analysis.
• Independent risk factors included lymphocyte count, maximum tumor diameter, alpha fetoprotein level, number of tumor lesions, and portal vein invasion.
• The nomogram achieved a C-index of 0.783 in the training cohort and 0.701 in the validation cohort.
• AUCs for 1, 3, and 5-year survival were 0.814, 0.895, and 0.825 in the training cohort, indicating strong predictive ability.
• Calibration curves showed good agreement between predicted and observed survival rates.

Interpretation:

The developed nomogram effectively predicts OS in HCC patients post-HIFU treatment, offering a more personalized approach to patient management compared to traditional staging systems.

Limitations:

• Retrospective design may introduce selection bias.
• Single-center study limits generalizability of findings.
• External validation in diverse populations is needed.

Conclusion:

The nomogram model can enhance prognostic accuracy and support personalized treatment strategies for HCC patients undergoing HIFU.