Risk score model for the development of hepatocellular carcinoma in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B.
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.
['Sohn|Won|W|', 'Cho|Ju-Yeon|JY|', 'Kim|Ji Hoon|JH|', 'Lee|Jung Il|JI|', 'Kim|Hyung Joon|HJ|', 'Woo|Min-Ah|MA|', 'Jung|Sin-Ho|SH|', 'Paik|Yong-Han|YH|0000-0002-3076-2327']
D000284:Administration, Oral D000328:Adult D000998:Antiviral Agents D019540:Area Under Curve D006528:Carcinoma, Hepatocellular D004279:DNA, Viral D005260:Female D006147:Guanine D006513:Hepatitis B e Antigens D006515:Hepatitis B virus D019694:Hepatitis B, Chronic D006801:Humans D015994:Incidence D008113:Liver Neoplasms D008297:Male D008875:Middle Aged D016016:Proportional Hazards Models D012372:ROC Curve D012189:Retrospective Studies D012307:Risk Factors
Hepatocellular carcinoma Chronic hepatitis B Antiviral drugs Assessment, Risk