Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus
The identification of patients with advanced fibrosis who do not need any further hepatocellular carcinoma (HCC) surveillance after the eradication of hepatitis C is pivotal. In this study, we developed a simple serum‐based risk model that could identify patients with low‐risk HCC. This was a nation...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2022-03-01
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| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1833 |
| _version_ | 1828046952656273408 |
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| author | Nobuharu Tamaki Masayuki Kurosaki Yutaka Yasui Nami Mori Keiji Tsuji Chitomi Hasebe Kouji Joko Takehiro Akahane Koichiro Furuta Haruhiko Kobashi Hiroyuki Kimura Hitoshi Yagisawa Hiroyuki Marusawa Masahiko Kondo Yuji Kojima Hideo Yoshida Yasushi Uchida Toshifumi Tada Shinichiro Nakamura Satoshi Yasuda Hidenori Toyoda Rohit Loomba Namiki Izumi |
| author_facet | Nobuharu Tamaki Masayuki Kurosaki Yutaka Yasui Nami Mori Keiji Tsuji Chitomi Hasebe Kouji Joko Takehiro Akahane Koichiro Furuta Haruhiko Kobashi Hiroyuki Kimura Hitoshi Yagisawa Hiroyuki Marusawa Masahiko Kondo Yuji Kojima Hideo Yoshida Yasushi Uchida Toshifumi Tada Shinichiro Nakamura Satoshi Yasuda Hidenori Toyoda Rohit Loomba Namiki Izumi |
| author_sort | Nobuharu Tamaki |
| collection | DOAJ |
| description | The identification of patients with advanced fibrosis who do not need any further hepatocellular carcinoma (HCC) surveillance after the eradication of hepatitis C is pivotal. In this study, we developed a simple serum‐based risk model that could identify patients with low‐risk HCC. This was a nationwide multicenter study involving 16 Hospitals in Japan. Patients with advanced fibrosis (1,325 in a derivation cohort and 508 in a validation cohort) who achieved sustained virological responses at 24 weeks after treatment (SVR24) were enrolled. The HCC risk model at any point after SVR24 and its change were evaluated, and subsequent HCC development was analyzed. Based on the multivariable analysis, patients fulfilling all of the factors (GAF4 criteria: gamma‐glutamyl transferase < 28 IU/L, alpha‐fetoprotein < 4.0 ng/mL, and Fibrosis‐4 Index < 4.28) were classified as low‐risk and others were classified as high‐risk. When patients were stratified at the SVR24, and 1 year, and 2 years after SVR24, subsequent HCC development was significantly lower in low‐risk patients (0.5‐1.1 per 100 person‐years in the derivation cohort and 0.9‐1.1 per 100 person‐years in the validation cohort) than in high‐risk patients at each point. HCC risk from 1 year after SVR24 decreased in patients whose risk improved from high‐risk to low‐risk (HCC incidence: 0.6 per 100 person‐years [hazard ratio (HR) = 0.163 in the derivation cohort] and 1.3 per 100 person‐years [HR = 0.239 in the validation cohort]) than in those with sustained high risk. Conclusion: The HCC risk model based on simple serum markers at any point after SVR and its change can identify patients with advanced fibrosis who are at low HCC risk, and these patients may be able to reduce HCC surveillance. |
| first_indexed | 2024-04-10T18:33:27Z |
| format | Article |
| id | doaj.art-b270c985294642f8ba44b40f73ac4f16 |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T18:33:27Z |
| publishDate | 2022-03-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-b270c985294642f8ba44b40f73ac4f162023-02-02T02:30:55ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2022-03-016346147210.1002/hep4.1833Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C VirusNobuharu Tamaki0Masayuki Kurosaki1Yutaka Yasui2Nami Mori3Keiji Tsuji4Chitomi Hasebe5Kouji Joko6Takehiro Akahane7Koichiro Furuta8Haruhiko Kobashi9Hiroyuki Kimura10Hitoshi Yagisawa11Hiroyuki Marusawa12Masahiko Kondo13Yuji Kojima14Hideo Yoshida15Yasushi Uchida16Toshifumi Tada17Shinichiro Nakamura18Satoshi Yasuda19Hidenori Toyoda20Rohit Loomba21Namiki Izumi22Department of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanDepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanDepartment of Gastroenterology Hiroshima Red Cross Hospital and Atomic‐bomb Survivors Hospital Hiroshima JapanDepartment of Gastroenterology Hiroshima Red Cross Hospital and Atomic‐bomb Survivors Hospital Hiroshima JapanDepartment of Gastroenterology Japanese Red Cross Asahikawa Hospital Asahikawa Hokkaido JapanCenter for Liver‐Biliary‐Pancreatic Disease Matsuyama Red Cross Hospital Matsuyama Ehime JapanDepartment of Gastroenterology Japanese Red Cross Ishinomaki Hospital Ishinomaki Miyagi JapanDepartment of Gastroenterology Masuda Red Cross Hospital Masuda Shimane JapanDepartment of Gastroenterology Japanese Red Cross Okayama Hospital Okayama Okayama JapanDepartment of Gastroenterology Japanese Red Cross Kyoto Daiichi Hospital Kyoto JapanDepartment of Gastroenterology Japanese Red Cross Akita Hospital Akita JapanDepartment of Gastroenterology and Hepatology Osaka Red Cross Hospital Osaka JapanDepartment of Gastroenterology Japanese Red Cross Otsu Hospital Otsu Shiga JapanDepartment of Hepatology Japanese Red Cross Ise Hospital Ise Mie JapanDepartment of Gastroenterology Japanese Red Cross Medical Center Tokyo JapanDepartment of Gastroenterology Matsue Red Cross Hospital Matsue Shimane JapanDepartment of Internal Medicine Japanese Red Cross Society Himeji Hospital Himeji JapanDepartment of Internal Medicine Japanese Red Cross Society Himeji Hospital Himeji JapanDepartment of Gastroenterology and Hepatology Ogaki Municipal Hospital Ogaki JapanDepartment of Gastroenterology and Hepatology Ogaki Municipal Hospital Ogaki JapanNAFLD Research Center Division of Gastroenterology and Hepatology Department of Medicine University of California San Diego La Jolla California USADepartment of Gastroenterology and Hepatology Musashino Red Cross Hospital Tokyo JapanThe identification of patients with advanced fibrosis who do not need any further hepatocellular carcinoma (HCC) surveillance after the eradication of hepatitis C is pivotal. In this study, we developed a simple serum‐based risk model that could identify patients with low‐risk HCC. This was a nationwide multicenter study involving 16 Hospitals in Japan. Patients with advanced fibrosis (1,325 in a derivation cohort and 508 in a validation cohort) who achieved sustained virological responses at 24 weeks after treatment (SVR24) were enrolled. The HCC risk model at any point after SVR24 and its change were evaluated, and subsequent HCC development was analyzed. Based on the multivariable analysis, patients fulfilling all of the factors (GAF4 criteria: gamma‐glutamyl transferase < 28 IU/L, alpha‐fetoprotein < 4.0 ng/mL, and Fibrosis‐4 Index < 4.28) were classified as low‐risk and others were classified as high‐risk. When patients were stratified at the SVR24, and 1 year, and 2 years after SVR24, subsequent HCC development was significantly lower in low‐risk patients (0.5‐1.1 per 100 person‐years in the derivation cohort and 0.9‐1.1 per 100 person‐years in the validation cohort) than in high‐risk patients at each point. HCC risk from 1 year after SVR24 decreased in patients whose risk improved from high‐risk to low‐risk (HCC incidence: 0.6 per 100 person‐years [hazard ratio (HR) = 0.163 in the derivation cohort] and 1.3 per 100 person‐years [HR = 0.239 in the validation cohort]) than in those with sustained high risk. Conclusion: The HCC risk model based on simple serum markers at any point after SVR and its change can identify patients with advanced fibrosis who are at low HCC risk, and these patients may be able to reduce HCC surveillance.https://doi.org/10.1002/hep4.1833 |
| spellingShingle | Nobuharu Tamaki Masayuki Kurosaki Yutaka Yasui Nami Mori Keiji Tsuji Chitomi Hasebe Kouji Joko Takehiro Akahane Koichiro Furuta Haruhiko Kobashi Hiroyuki Kimura Hitoshi Yagisawa Hiroyuki Marusawa Masahiko Kondo Yuji Kojima Hideo Yoshida Yasushi Uchida Toshifumi Tada Shinichiro Nakamura Satoshi Yasuda Hidenori Toyoda Rohit Loomba Namiki Izumi Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus Hepatology Communications |
| title | Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus |
| title_full | Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus |
| title_fullStr | Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus |
| title_full_unstemmed | Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus |
| title_short | Hepatocellular Carcinoma Risk Assessment for Patients With Advanced Fibrosis After Eradication of Hepatitis C Virus |
| title_sort | hepatocellular carcinoma risk assessment for patients with advanced fibrosis after eradication of hepatitis c virus |
| url | https://doi.org/10.1002/hep4.1833 |
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