Clin Mol Hepatol.  2017 Jun;23(2):170-178. 10.3350/cmh.2016.0086.

Risk score model for the development of hepatocellular carcinoma in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B

• Sohn W
• Cho JY
• Kim JH
• Lee JI
• Kim HJ
• Woo MA
• Jung SH
• Paik YH

• KMID: 2413121
• DOI: http://doi.org/10.3350/cmh.2016.0086

Abstract

BACKGROUND/AIMS
This study aimed to develop and validate a risk prediction model for the development of hepatocellular carcinoma (HCC) in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B (CHB).
METHODS
We investigated 2,061 Korean treatment-naïve patients with CHB treated with entecavir as an initial therapy. A risk score model for HCC development was developed based on multivariable Cox regression model in a single center (n=990) and was validated using the time-dependent area under the receiver operating characteristic curve (AUROC) in three other centers (n=1,071). The difference of HCC development among risk groups (low, intermediate, and high) categorized by risk score was also investigated.
RESULTS
The cumulative incidence rates of HCC at 5 years were 11.2% and 8.9% in the testing and validation cohorts, respectively. HCC-Risk Estimating Score in CHB patients Under Entecavir (HCC-RESCUE) is formulated as (age+15×gender [female=0 / male=1]+23×cirrhosis [absence=0 / presence=1]). The AUROCs at 1 year, 3 years, and 5 years were 0.82, 0.81, and 0.81, respectively, in the validation cohort. A significant difference of HCC development in each risk group was determined by the 5-year HCC risk score in the validation cohort (low risk group, 2.1%; intermediate risk group, 9.3%; high risk group, 41.2%, p<0.001).
CONCLUSIONS
The study presents a new risk score model with a good ability to predict HCC development and determine high risk patients for HCC development consisting of readily available clinical factors in treatment-naïve CHB patients receiving entecavir.

Keyword

Chronic hepatitis B; Hepatocellular carcinoma; Assessment, Risk; Antiviral drugs

MeSH Terms

Administration, Oral
Adult
Antiviral Agents/*therapeutic use
Area Under Curve
Carcinoma, Hepatocellular/*diagnosis/epidemiology/etiology
DNA, Viral/blood/genetics/metabolism
Female
Guanine/*analogs & derivatives/therapeutic use
Hepatitis B e Antigens/blood
Hepatitis B virus/isolation & purification
Hepatitis B, Chronic/complications/*drug therapy/virology
Humans
Incidence
Liver Neoplasms/*diagnosis/epidemiology/etiology
Male
Middle Aged
Proportional Hazards Models
ROC Curve
Retrospective Studies
Risk Factors
Antiviral Agents
DNA, Viral
Hepatitis B e Antigens
Guanine