Nomogram-Based risk stratification system
The overall prognostic score for each patient was calculated based on variables within the nomogram. Two optimal cutoff values were identified at 140 and 223 scores using X-tile software. Utilizing these thresholds, patients were stratified into low, intermediate, and high-risk groups, consisting of 1100 patients (50.3%, total score ≤ 140), 831 patients (38.0%, 140 < total score < 223), and 254 patients (11.6%, total score ≥ 223), respectively. The OS rates for the low-risk group were 98.7%, 97.4%, and 97.0% at 1, 3, and 5 years, respectively. In the intermediate-risk group, the OS rates were marginally lower at 90.0%, 77.1%, and 70.4% at 1, 3, and 5 years, respectively. However, patients in the high-risk group exhibited a substantially worse prognosis, with OS rates of merely 86.7%, 61.6%, and 46.9% at 1, 3, and 5 years, respectively (Fig. Establishment of a risk stratification system through the optimal cut-off value of the risk score. 