The applicability of hepatocellular carcinoma risk prediction scores in a North American patient population with chronic hepatitis B infection

Abu‐Amara, Mahmoud; Cerocchi, Orlando; Malhi, Gurtej; Sharma, Suraj; Yim, Colina; Shah, Hemant; Wong, David; Janssen, Harry L.A.; Feld, Jordan J.

doi:10.1136/gutjnl-2014-309099

Cited by 41 publications

(49 citation statements)

References 23 publications

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“…Other risk scoring systems, such as the GAG-HCC and CU-HCC, consider factors such as presence of cirrhosis and core promoter mutations and may be more accurate, particularly for non-Asian cohorts. 32 HCC risk scoring systems for patients receiving antiviral therapy with adequate viral suppression, and/or in other racial/ethnic groups, including patients from the US and Europe, require further evaluation. 33 …”

Section: Translating Epidemiology Into Risk Stratification In Clinicamentioning

confidence: 99%

Hepatocellular Carcinoma From Epidemiology to Prevention: Translating Knowledge into Practice

Singal

El–Serag

2015

Clinical Gastroenterology and Hepatology

460

369

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Hepatocellular carcinoma (HCC) is the 3rd leading cause of cancer-related death worldwide and one of the leading causes of death in patients with cirrhosis.1]HCC incidence in the United States (US) has more than doubled over the past 2 decades and is anticipated to continue increasing over the next 20 y, due to the growing number of patients with advanced hepatitis C virus (HCV) and/or non-alcoholic steatohepatitis (NASH). At its current pace, HCC is projected to surpass breast and colorectal cancer to become the 3rd leading cause of cancer-related death in the US by 2030.2 Currently only 46% of HCC cases are diagnosed at an early stage and most do not receive curative therapy.2 Epidemiologic and clinical studies have identified many factors that affect risk for HCC and can be used to identify at-risk patients and implement prevention measures. Although several advances in HCC prevention, early detection, and diagnosis are efficacious and could reduce the incidence and mortality of HCC, widespread dissemination and successful implementation are essential for these strategies to be effective in clinical practice. Challenges include limited recognition of at-risk patients, availability of well-validated risk stratification measures, and surveillance in high-risk groups.

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Section: Translating Epidemiology Into Risk Stratification In Clinicamentioning

confidence: 99%

Hepatocellular Carcinoma From Epidemiology to Prevention: Translating Knowledge into Practice

Singal

El–Serag

2015

Clinical Gastroenterology and Hepatology

460

369

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“…In Western areas, Asian models were shown to be somewhat less predictive, and those that incorporated parameters of liver function or cirrhosis were the most accurate . However, the small sample size and the heterogeneity of the population chronically infected with HBV combined with the low rates of HCC significantly limited the conclusions.…”

Section: Introductionmentioning

confidence: 99%

Non‐virological factors are drivers of hepatocellular carcinoma in virosuppressed hepatitis B cirrhosis: Results of ANRS CO12 CirVir cohort

Brichler

Nahon

Zoulim

et al. 2019

Journal of Viral Hepatitis

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Summary Worldwide, hepatocellular carcinoma (HCC) occurs mainly in Asian patients with hepatitis B virus (HBV) infection. This study aimed to decipher the environmental and virological factors associated with HCC occurrence and validate risk scoring systems in a French multicentre prospective cohort of HBV cirrhotic patients. Patients with biopsy‐proven Child‐Pugh A viral cirrhosis included in the ANRS CO12 CirVir cohort who were HBsAg(+) without hepatitis C coinfection were selected for: (a) interview through a standardized questionnaire reporting coffee consumption and HCC familial history; (b) HBsAg quantification using baseline and sequential 2‐year frozen sera; (c) baseline HBV genotype determination; and (d) assessment of risk factors and applicability of HCC risk scores (Kaplan‐Meier analysis, Cox models). Among 317 patients studied (261 men, median age 53 years, past or ongoing antiviral treatment 93.3% and baseline detectable HBV DNA in 88 patients), the baseline and 2‐year median HBsAg levels were 810 and 463 IU/mL, respectively. After a median follow‐up of 65.2 months, 27 HCC cases were diagnosed (annual incidence: 1.6%). Three factors were independently associated with HCC occurrence: age > 50 years, platelets ≤ 150 × 103/mm3 and body mass index ≥ 30 kg/m2. Two out of five risk scores were validated, and the most accurate was PAGE‐B at 1 year. Moreover, HCC in patients without maintained virological suppression seems more aggressive and less accessible to curative treatment. In conclusion, in French patients with HBV cirrhosis mostly virally suppressed, independent HCC risk factors were host‐related (age, obesity) or linked to the severity of cirrhosis (thrombopenia), and the European PAGE‐B score was the most accurate risk score.

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“…These models were developed in Asians and the application to other populations is unclear, though one study showed good performance in non-Asians [44] . The platelet, age, gender (PAGE-B score is based on platelet, age and gender and was developed to assess risk of HCC in Caucasians.…”

Section: Limitations Of the Hcc Predictor Modelsmentioning

confidence: 99%

The impact of nucleos(t)ide analog therapy in hepatitis B on the incidence of hepatocellular carcinoma: an update including recent literature findings

Ayoub¹,

Dailey²,

Martin³

et al. 2017

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How to cite this article: Ayoub WS, Dailey F, Martin P, Jones PD. The impact of nucleos(t)ide analog therapy in hepatitis B on the incidence of hepatocellular carcinoma: an update including recent literature findings. Hepatoma Res 2017;3:302-8.Worldwide, hepatocellular carcinoma (HCC) is a significant cause of morbidity and mortality. In men, it is the fifth most common cancer and seventh most common in women; HCC is the second highest cause of cancer-related death worldwide. It is less prevalent in the USA and Northern Europe and more prevalent in Eastern and South-Eastern Asia. Over 700,000 cases are diagnosed each year -half of which occur in China -and result in roughly the same number of deaths per year. HCC significantly impairs quality of life and is associated with great costs to society. It is estimated that half of the deaths from HCC are associated with hepatitis B virus (HBV). Fortunately, HBV vaccination and antiviral therapy have shown excellent efficacy in decreasing the incidence of HCC. We will discuss the relationship of HBV to HCC, address available treatments for HBV and the impact of treatment on the development of HCC. Key words:Liver cancer, hepatocellular carcinoma, hepatitis B, nucleos(t)ides, entecavir; tenofovir, lamivudine ABSTRACTArticle history:

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The applicability of hepatocellular carcinoma risk prediction scores in a North American patient population with chronic hepatitis B infection

Abstract: Although all models predicted the risk of HCC, models that incorporated parameters of liver function or cirrhosis (CU-HCC/GAG-HCC) were most accurate. Low-risk patients likely require reduced HCC surveillance.

Cited by 41 publications

References 23 publications

Hepatocellular Carcinoma From Epidemiology to Prevention: Translating Knowledge into Practice

Hepatocellular Carcinoma From Epidemiology to Prevention: Translating Knowledge into Practice

Non‐virological factors are drivers of hepatocellular carcinoma in virosuppressed hepatitis B cirrhosis: Results of ANRS CO12 CirVir cohort

The impact of nucleos(t)ide analog therapy in hepatitis B on the incidence of hepatocellular carcinoma: an update including recent literature findings

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