TY - JOUR
T1 - PAGE-B
T2 - A risk score for hepatocellular carcinoma in Caucasians with chronic hepatitis B under a 5-year entecavir or tenofovir therapy
AU - Papatheodoridis, George
AU - Dalekos, George
AU - Sypsa, Vana
AU - Yurdaydin, Cihan
AU - Buti, Maria
AU - Goulis, John
AU - Calleja, Jose Luis
AU - Chi, Heng
AU - Manolakopoulos, Spilios
AU - Mangia, Giampaolo
AU - Gatselis, Nikolaos
AU - Keskin, Onur
AU - Savvidou, Savvoula
AU - de la Revilla, Juan
AU - Hansen, Bettina E.
AU - Vlachogiannakos, Ioannis
AU - Galanis, Kostantinos
AU - Idilman, Ramazan
AU - Colombo, Massimo
AU - Esteban, Rafael
AU - Janssen, Harry L A
AU - Lampertico, Pietro
PY - 2015/6/30
Y1 - 2015/6/30
N2 - 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 ≥12months. 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 17 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.
AB - 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 ≥12months. 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 17 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.
KW - Entecavir
KW - Hepatitis B
KW - Hepatocellular carcinoma
KW - Tenofovir
UR - http://www.scopus.com/inward/record.url?scp=84955316940&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84955316940&partnerID=8YFLogxK
U2 - 10.1016/j.jhep.2015.11.035
DO - 10.1016/j.jhep.2015.11.035
M3 - Article
AN - SCOPUS:84955316940
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
ER -