Clinically interpretable nomogram combining body composition and clinicopathological features for one year survival prediction in advanced solid tumors
Immune checkpoint inhibitors (ICIs) have improved outcomes for patients with solid tumors, but reliable predictors of overall survival (OS) are limited. This retrospective study of 146 advanced solid tumor patients treated with ICIs aims to provide a nomogram to predict 1-year (1y) OS integrating body composition (BC) parameters with standard clinicopathological (CP) features. A two-stage approach was implemented: first random survival forest models were trained and tested to evaluate the prognostic value of (a) CP features alone, (b) BC metrics alone or as newly introduced BC scores, and (c) their combination. The best predictive performance (average cumulative AUC of 0.73 in test set) was achieved by combining 12 CP features with the BC score comprising intramuscolar adipose tissue content, visceral fat area index, and the visceral-to-subcutaneous fat area index ratio. Finally, a nomogram was developed with this feature set, offering a tool for personalized risk stratification and treatment planning (mean absolute error in calibration curve of 0.03 and overall AUC of 0.76). Integrating BC parameters with CP features substantially enhances 1y OS prediction in patients receiving ICIs.
Authors
- Valeria Cognigni (ORCID: https://orcid.org/0009-0001-4895-2727)
- L. Burattini
- Alessandra Borgheresi (ORCID: https://orcid.org/0000-0002-5544-9468)
- Valentina Lunerti
- Riccardo Giampieri (ORCID: https://orcid.org/0000-0001-7344-0590)
- Kamal S. Saini (ORCID: https://orcid.org/0000-0001-6301-3309)
- Arianna Vignini (ORCID: https://orcid.org/0000-0002-2496-7932)
- M. Gualtieri
- Rossana Berardi (ORCID: https://orcid.org/0000-0002-9529-2960)
- Alessandro Parisi (ORCID: https://orcid.org/0000-0003-4629-7762)
- Giulia Bruschi (ORCID: https://orcid.org/0009-0000-7075-7330)
- Salvatore Ficarra (ORCID: https://orcid.org/0000-0001-9975-6542)
- T. Galassi
- Natalia Chiodi
- Giulia Mentrasti
- Agnese Sbrollini (ORCID: https://orcid.org/0000-0002-9152-7216)
- L. Santamaria
- Veronica Agostinelli (ORCID: https://orcid.org/0000-0002-9410-1528)
- Marzia Di Pietro Paolo (ORCID: https://orcid.org/0000-0002-9136-754X)
- F. Pecci
- Francesco Paoloni (ORCID: https://orcid.org/0000-0002-8992-3578)
- G. Mazzaschi
- Luca Cantini
- Andrea Agostini
- Andrea Giovagnoni
- Marcello Tiseo
- Sebastiano Buti
- Elisabetta Tola
Institutions
- Marche Polytechnic University (IT)
- University of Parma (IT)
- Harvard University (US)
- Cambridge University Hospitals NHS Foundation Trust (GB)
- Dana-Farber Cancer Institute (US)
- Ospedale di Parma (IT)
- Addenbrooke's Hospital (GB)
Publication Details
- Journal
- Scientific Reports
- Published
- 2026-03-12
- DOI
- https://doi.org/10.1038/s41598-026-37510-1
- Primary Topic
- Nutrition and Health in Aging
- Type
- article
- Field-Weighted Citation Impact
- 0.00