Τίτλος:
PAGE-B predicts the risk of developing hepatocellular carcinoma in Caucasians with chronic hepatitis B on 5-year antiviral therapy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Papatheodoridis, G.
Dalekos, G.
Sypsa, V.
Yurdaydin, C.
Buti, M.
Goulis, J.
Calleja, J.L.
Chi, H.
Manolakopoulos, S.
Mangia, G.
Gatselis, N.
Keskin, O.
Savvidou, S.
De La Revilla, J.
Hansen, B.E.
Vlachogiannakos, I.
Galanis, K.
Idilman, R.
Colombo, M.
Esteban, R.
Janssen, H.L.A.
Lampertico, P.
Περιοδικό:
WORLD JOURNAL OF HEPATOLOGY
Λέξεις-κλειδιά:
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
DOI:
10.1016/j.jhep.2015.11.035
