Liver stiffness‐based score in hepatoma risk assessment for chronic hepatitis C patients after successful antiviral therapy. (28th June 2016)

• Record Type: Journal Article
• Authors: Wang, Jing‐Houng; Yen, Yi‐Hao; Yao, Chih‐Chien; Hung, Chao‐Hung; Chen, Chien‐Hung; Hu, Tsung‐Hui; Lee, Chuan‐Mo; Lu, Sheng‐Nan
• Is Part Of: Liver international. Volume 36:Number 12(2016)
• Page Start: 1793
• Page End: 1799
• Publication Date: 2016-06-28
• Subjects: chronic hepatitis C -- hepatocellular carcinoma -- interferon‐based therapy -- liver stiffness measurement -- sustained virological response -- transient elastography; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13179
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background & Aims: Patients with chronic hepatitis C (CHC) after successful antiviral therapy remain at risk of hepatocellular carcinoma (HCC). This study was to determine whether liver stiffness measurement (LSM) was useful in HCC risk assessment and to develop a risk‐score system for clinical use. Methods: This retrospective study enrolled patients with CHC achieving sustained virological response (SVR) after interferon‐based therapy with LSM at/after SVR determination. The demographics, clinical characteristics and HCC development were obtained from medical chart reviews. The diagnosis of HCC was based on recommended criteria. Results: A total of 376 (M/F: 185/191, mean age: 54.1 years) patients, including 278 with pretreatment liver biopsy specimens, with a median follow‐up period of 7.6 years were enrolled. Twenty‐one patients developed HCC. The 5‐ and 10‐year cumulative HCC incidences were 1.4% and 7.8%, respectively. Multivariate analysis showed advanced fibrosis/cirrhosis, diabetes and LSM were associated with HCC developments with odds ratio (OR) of 12.38, 2.80 and 1.01, respectively. For LSM in HCC prediction, the performance and cut‐off were 0.783 and 12 kilopascal (kPa), respectively. For 278 patients with pretreatment biopsy, a risk‐score system (score 0–4) combining advanced fibrosis/cirrhosis, diabetes and LSM >12 kPa was developed. With the low‐risk group as a reference, patients in intermediate‐ (OR: 12.57) and high‐risk (OR: 197.33) groups carried higher risk of HCC development. Conclusions: For patients with CHC achieving SVR, liver stiffness value at/after SVR determination was associated with HCC development independently. Patients with pretreatment advanced fibrosis/cirrhosis, diabetes and LSM >12 kPa after SVR were at high risk of HCC development.