@article{3124511,
    title = "PAGE-B predicts the risk of developing hepatocellular carcinoma in Caucasians with chronic hepatitis B on 5-year antiviral therapy",
    author = "Papatheodoridis, G. and Dalekos, G. and Sypsa, V. and Yurdaydin, C. and Buti, M. and Goulis, J. and Calleja, J.L. and Chi, H. and Manolakopoulos, S. and Mangia, G. and Gatselis, N. and Keskin, O. and Savvidou, S. and De La Revilla, J. and Hansen, B.E. and Vlachogiannakos, I. and Galanis, K. and Idilman, R. and Colombo, M. and Esteban, R. and Janssen, H.L.A. and Lampertico, P.",
    journal = "WORLD JOURNAL OF HEPATOLOGY",
    year = "2016",
    volume = "64",
    number = "4",
    pages = "800-806",
    publisher = "Elsevier B.V.",
    doi = "10.1016/j.jhep.2015.11.035",
    keywords = "entecavir;  tenofovir;  antivirus agent;  entecavir;  guanine;  tenofovir, adult;  age;  antiviral therapy;  Article;  cancer incidence;  cancer risk;  Caucasian;  chronic hepatitis B;  controlled study;  digestive system disease assessment;  female;  gender;  human;  liver cell carcinoma;  liver cirrhosis;  major clinical study;  male;  PAGE B score;  priority journal;  risk assessment;  treatment duration;  validation process;  aged;  analogs and derivatives;  Carcinoma, Hepatocellular;  clinical trial;  cohort analysis;  complication;  Hepatitis B, Chronic;  Liver Neoplasms;  middle aged;  multicenter study;  proportional hazards model;  risk, Adult;  Aged;  Antiviral Agents;  Carcinoma, Hepatocellular;  Cohort Studies;  Female;  Guanine;  Hepatitis B, Chronic;  Humans;  Liver Neoplasms;  Male;  Middle Aged;  Proportional Hazards Models;  Risk;  Tenofovir",
    abstract = "Background & Aims Risk scores for hepatocellular carcinoma (HCC) developed in Asians offer poor-moderate predictability in Caucasian patients with chronic hepatitis B (CHB). This nine center cohort study aimed to develop and validate an accurate HCC risk score in Caucasian CHB patients treated with the current oral antivirals, entecavir/tenofovir. Methods We included 1815 adult Caucasians with CHB and no HCC at baseline who received entecavir/tenofovir for ≥12 months. Using data from eight centers (derivation dataset, n = 1325), a HCC risk score was developed based on multivariable Cox models and points system for simplification. Harrell's c-index was used as discrimination, bootstrap for internal validation and the data from the 9th and largest center (validation dataset, n = 490) for external validation. Results The 5-year cumulative HCC incidence rates were 5.7% and 8.4% in the derivation and validation dataset, respectively. In the derivation dataset, age, gender, platelets and cirrhosis were independently associated with HCC. The PAGE-B score was developed based on age, gender and platelets (c-index = 0.82, 0.81 after bootstrap validation). The addition of cirrhosis did not substantially improve the discrimination (c-index = 0.84). The predictability of PAGE-B score was similar (c-index = 0.82) in the validation dataset. Patients with PAGE-B ≤9, 10-17, ≥18 had 5-year cumulative HCC incidence rates of 0%, 3%, 17% in the derivation and 0%, 4%, 16% in the validation dataset. Conclusion PAGE-B, which is based only on baseline patients' age, gender and platelets, represents a simple and reliable score for prediction of the 5-year HCC risk in Caucasian CHB patients under entecavir/tenofovir. © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved."
}