TY - JOUR
TI - PAGE-B predicts the risk of developing hepatocellular carcinoma in Caucasians with chronic hepatitis B on 5-year antiviral therapy
AU - Papatheodoridis, G.
AU - Dalekos, G.
AU - Sypsa, V.
AU - Yurdaydin, C.
AU - Buti, M.
AU - Goulis, J.
AU - Calleja, J.L.
AU - Chi, H.
AU - Manolakopoulos, S.
AU - Mangia, G.
AU - Gatselis, N.
AU - Keskin, O.
AU - Savvidou, S.
AU - De La Revilla, J.
AU - Hansen, B.E.
AU - Vlachogiannakos, I.
AU - Galanis, K.
AU - Idilman, R.
AU - Colombo, M.
AU - Esteban, R.
AU - Janssen, H.L.A.
AU - Lampertico, P.
JO - WORLD JOURNAL OF HEPATOLOGY
PY - 2016
VL - 64
TODO - 4
SP - 800-806
PB - Elsevier B.V.
SN - null
TODO - 10.1016/j.jhep.2015.11.035
TODO - 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
TODO - 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.
ER -