Development and internal validation of a prognostic model for hepatocellular carcinoma after liver resection based on the albumin-bilirubin score and triglyceride-glucose index

Background: Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality. Surgical resection offers a curative option, but outcomes vary widely. Accurate preoperative risk stratification is essential. This study evaluated the prognostic value of the albumin-bilirubin (ALBI) score and triglyceride-glucose (TyG) index-markers of liver function and metabolic status-in patients undergoing curative liver resection. Methods: This retrospective study included 238 patients with pathologically confirmed HCC who underwent curative liver resection. Preoperative clinical and biochemical variables were collected, and a prognostic model was developed using the entire dataset. Multivariate Cox proportional hazards regression was performed to identify independent prognostic factors. A nomogram incorporating the ALBI score and TyG index was constructed to estimate 2-, 3-, and 4-year overall survival (OS). Model performance was assessed through Kaplan-Meier survival analysis, receiver operating characteristic (ROC) curves, calibration plot, and decision curve analysis (DCA). Bootstrap resampling was used for internal validation to generate corrected estimates of model accuracy. Results: Multivariate Cox regression demonstrated that both the ALBI score [hazard ratio (HR) =5.120; 95% confidence interval (CI): 2.944-8.905; P