Hwai-I Yang1,2, Ming-Lun Yeh3, Grace L Wong4, Cheng-Yuan Peng5, Chien-Hung Chen6, Huy N Trinh7, Ka-Shing Cheung8, Qing Xie9, Tung-Hung Su10, Ritsuzo Kozuka11, Dong-Hyun Lee12, Eiichi Ogawa13, Changqing Zhao14, Hui-Bin Ning15, Rui Huang16, Jiayi Li17, Jian Q Zhang18, Tatsuya Ide19, Huichun Xing20, Shinji Iwane21, Hirokazu Takahashi21, Christopher Wong22, Clifford Wong22, Chia-Hsin Lin5, Joseph Hoang23, An Le23, Linda Henry23, Hidenori Toyoda24, Yoshiyuki Ueno25, Edward J Gane26, Yuichiro Eguchi21, Masayuki Kurosaki27, Chao Wu16, Chenghai Liu14, Jia Shang15, Norihiro Furusyo13, Masaru Enomoto11, Jia-Horng Kao10, Man-Fung Yuen8, Ming-Lung Yu3, Mindie H Nguyen23. 1. Genomics Research Center, Academia Sinica, Taipei, Taiwan. 2. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. 3. Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 4. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong. 5. Department of Gastroenterology, China Medical University Hospital, Taichung, Taiwan. 6. Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. 7. San Jose Gastroenterology, San Jose, California, USA. 8. Department of Medicine, The University of Hong Kong, Hong Kong. 9. Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Peopole's Republic of China. 10. Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. 11. Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan. 12. Department of Gastroenterology, Good Gang-An Hospital, Busan, South Korea. 13. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. 14. Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, Peopole's Republic of China. 15. Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, Peopole's Republic of China. 16. Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, Peopole's Republic of China. 17. Palo Alto Medical Foundation, Mountain View Division, Mountain View, California, USA. 18. Chinese Hospital, San Francisco, California, USA. 19. Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan. 20. Beijing Ditan Hospital, Capital Medical University, Beijing, Peopole's Republic of China. 21. Department of Internal Medicine, Saga University Hospital, Saga, Japan. 22. Wong Clinics, San Francisco, California, USA. 23. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California, USA. 24. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan. 25. Department of Gastroenterology, Yamagata University, Yamagata, Japan. 26. Liver Transplant Unit, University of Auckland, Auckland, New Zealand. 27. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
Abstract
BACKGROUND: Patients on oral antiviral (OAV) therapy remain at hepatocellular carcinoma (HCC) risk. Risk prediction tools distinguishing treated patients with residual HCC risk are limited. The aim of this study was to develop an accurate, precise, simple-to-use HCC risk score using routine clinical variables among a treated Asian cohort. METHODS: Adult Asian chronic hepatitis B (CHB) patients on OAV were recruited from 25 centers in the United States and the Asia-Pacific region. Excluded persons were coinfected with hepatitis C, D, or human immunodeficiency virus, had HCC before or within 1 year of study entry, or their follow-up was <1 year. Patients were randomized to derivation and validation cohorts on a 2:1 ratio. Statistically significant predictors from multivariate modeling formed the Real-world Effectiveness from the Asia Pacific Rim Liver Consortium for HBV (REAL-B) score. RESULTS: A total of 8048 patients were randomized to the derivation (n = 5365) or validation group (n = 2683). The REAL-B model included 7 variables (male gender, age, alcohol use, diabetes, baseline cirrhosis, platelet count, and alpha fetoprotein), and scores were categorized as follows: 0-3 low risk, 4-7 moderate risk, and 8-13 high risk. Area under receiver operating characteristics were >0.80 for HCC risk at 3, 5, and 10 years, and these were significantly higher than other risk models (p < .001). CONCLUSIONS: The REAL-B score provides 3 distinct risk categories for HCC development in Asian CHB patients on OAV guiding HCC surveillance strategy.
BACKGROUND:Patients on oral antiviral (OAV) therapy remain at hepatocellular carcinoma (HCC) risk. Risk prediction tools distinguishing treated patients with residual HCC risk are limited. The aim of this study was to develop an accurate, precise, simple-to-use HCC risk score using routine clinical variables among a treated Asian cohort. METHODS: Adult Asian chronic hepatitis B (CHB) patients on OAV were recruited from 25 centers in the United States and the Asia-Pacific region. Excluded persons were coinfected with hepatitis C, D, or human immunodeficiency virus, had HCC before or within 1 year of study entry, or their follow-up was <1 year. Patients were randomized to derivation and validation cohorts on a 2:1 ratio. Statistically significant predictors from multivariate modeling formed the Real-world Effectiveness from the Asia Pacific Rim Liver Consortium for HBV (REAL-B) score. RESULTS: A total of 8048 patients were randomized to the derivation (n = 5365) or validation group (n = 2683). The REAL-B model included 7 variables (male gender, age, alcohol use, diabetes, baseline cirrhosis, platelet count, and alpha fetoprotein), and scores were categorized as follows: 0-3 low risk, 4-7 moderate risk, and 8-13 high risk. Area under receiver operating characteristics were >0.80 for HCC risk at 3, 5, and 10 years, and these were significantly higher than other risk models (p < .001). CONCLUSIONS: The REAL-B score provides 3 distinct risk categories for HCC development in Asian CHB patients on OAV guiding HCC surveillance strategy.
Authors: Francesco Paolo Russo; Alberto Zanetto; Elisa Pinto; Sara Battistella; Barbara Penzo; Patrizia Burra; Fabio Farinati Journal: Int J Mol Sci Date: 2022-01-02 Impact factor: 5.923
Authors: Hye Won Lee; Hyun Woong Lee; Jae Seung Lee; Yun Ho Roh; Hyein Lee; Seung Up Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Beom Kyung Kim Journal: J Hepatocell Carcinoma Date: 2021-05-25