Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B

Objectives: Predicting hepatocellular carcinoma (HCC) in patients with chronic hepatitis B who received long-term therapy with potent nucleos(t)ide analogs is of utmost importance to refine the strategy for HCC surveillance. Methods: We conducted a multicenter retrospective cohort study to validate...

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Autores principales:	Jihye Lim, Young Eun Chon, Mi Na Kim, Joo Ho Lee, Seong Gyu Hwang, Han Chu Lee, Yeonjung Ha
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	validation prediction CAGE-B SAGE-B hepatocellular carcinoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/8b23d2cf60044c83aecaa663e55fb226
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spelling	oai:doaj.org-article:8b23d2cf60044c83aecaa663e55fb2262021-11-25T17:01:30ZCirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B10.3390/cancers132256092072-6694https://doaj.org/article/8b23d2cf60044c83aecaa663e55fb2262021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5609https://doaj.org/toc/2072-6694Objectives: Predicting hepatocellular carcinoma (HCC) in patients with chronic hepatitis B who received long-term therapy with potent nucleos(t)ide analogs is of utmost importance to refine the strategy for HCC surveillance. Methods: We conducted a multicenter retrospective cohort study to validate the CAGE-B and SAGE-B scores, HCC prediction models developed for Caucasian patients receiving entecavir (ETV) or tenofovir (TFV) for >5 years. Consecutive patients who started ETV or TFV at two hospitals in Korea from January 2009 to December 2015 were identified. The prediction scores were calculated, and model performance was assessed using receiver operating characteristics (ROC) curves. Results: Among 1557 patients included, 57 (3.7%) patients had HCC during a median follow-up of 93 (95% confidence interval, 73–119) months. In the entire cohort, CAGE-B predicted HCC with an area under the ROC curve of 0.78 (95% CI, 0.72–0.84). Models that have “liver cirrhosis” in the calculation, such as AASL (0.79 (0.72–0.85)), CU-HCC (0.77 (0.72–0.82)), and GAG-HCC (0.79 (0.74–0.85)), showed accuracy similar to that of CAGE-B (<i>p</i> > 0.05); however, models without “liver cirrhosis”, including SAGE-B (0.71 (0.65–0.78)), showed a lower predictive ability than CAGE-B. CAGE-B performed well in subgroups of patients treated without treatment modification (0.81 (0.73–0.88)) and of male sex (0.79 (0.71–0.86)). Conclusions: This study validated the clinical usefulness of the CAGE-B score in a large number of Asian patients treated with long-term ETV or TFV. The results could provide the basis for the reappraisal of HCC surveillance strategies and encourage future prospective validation studies with liver stiffness measurements.Jihye LimYoung Eun ChonMi Na KimJoo Ho LeeSeong Gyu HwangHan Chu LeeYeonjung HaMDPI AGarticlevalidationpredictionCAGE-BSAGE-Bhepatocellular carcinomaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5609, p 5609 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	validation prediction CAGE-B SAGE-B hepatocellular carcinoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	validation prediction CAGE-B SAGE-B hepatocellular carcinoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jihye Lim Young Eun Chon Mi Na Kim Joo Ho Lee Seong Gyu Hwang Han Chu Lee Yeonjung Ha Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B
description	Objectives: Predicting hepatocellular carcinoma (HCC) in patients with chronic hepatitis B who received long-term therapy with potent nucleos(t)ide analogs is of utmost importance to refine the strategy for HCC surveillance. Methods: We conducted a multicenter retrospective cohort study to validate the CAGE-B and SAGE-B scores, HCC prediction models developed for Caucasian patients receiving entecavir (ETV) or tenofovir (TFV) for >5 years. Consecutive patients who started ETV or TFV at two hospitals in Korea from January 2009 to December 2015 were identified. The prediction scores were calculated, and model performance was assessed using receiver operating characteristics (ROC) curves. Results: Among 1557 patients included, 57 (3.7%) patients had HCC during a median follow-up of 93 (95% confidence interval, 73–119) months. In the entire cohort, CAGE-B predicted HCC with an area under the ROC curve of 0.78 (95% CI, 0.72–0.84). Models that have “liver cirrhosis” in the calculation, such as AASL (0.79 (0.72–0.85)), CU-HCC (0.77 (0.72–0.82)), and GAG-HCC (0.79 (0.74–0.85)), showed accuracy similar to that of CAGE-B (<i>p</i> > 0.05); however, models without “liver cirrhosis”, including SAGE-B (0.71 (0.65–0.78)), showed a lower predictive ability than CAGE-B. CAGE-B performed well in subgroups of patients treated without treatment modification (0.81 (0.73–0.88)) and of male sex (0.79 (0.71–0.86)). Conclusions: This study validated the clinical usefulness of the CAGE-B score in a large number of Asian patients treated with long-term ETV or TFV. The results could provide the basis for the reappraisal of HCC surveillance strategies and encourage future prospective validation studies with liver stiffness measurements.
format	article
author	Jihye Lim Young Eun Chon Mi Na Kim Joo Ho Lee Seong Gyu Hwang Han Chu Lee Yeonjung Ha
author_facet	Jihye Lim Young Eun Chon Mi Na Kim Joo Ho Lee Seong Gyu Hwang Han Chu Lee Yeonjung Ha
author_sort	Jihye Lim
title	Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B
title_short	Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B
title_full	Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B
title_fullStr	Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B
title_full_unstemmed	Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B
title_sort	cirrhosis, age, and liver stiffness-based models predict hepatocellular carcinoma in asian patients with chronic hepatitis b
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8b23d2cf60044c83aecaa663e55fb226
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Cirrhosis, Age, and Liver Stiffness-Based Models Predict Hepatocellular Carcinoma in Asian Patients with Chronic Hepatitis B

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