ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2023
Risk Stratification Model for Hepatocellular Cancer in Patients With Cirrhosis.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review.Gastroenterology · 2026Guideline
- Validation of Texas Hepatocellular Carcinoma Consortium Risk Index in the Hepatocellular Carcinoma Early Detection Strategy Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Evaluating a Polygenic Risk Score for Hepatocellular Carcinoma in Multiethnic Cirrhosis Patients in Texas.Cancer medicine · 2026Article
- Effects of laparoscopic splenectomy and azygoportal disconnection on liver reserve function for cirrhosis patients: a 1-year prospective study.Surgical endoscopy · 2026Article
- Bioimpedance Analysis to Predict Clinical Outcomes of Liver Cirrhosis in a Prospective Cohort Study.JGH open : an open access journal of gastroenterology and hepatology · 2026Article
- Risk-stratified surveillance for hepatocellular carcinoma.Hepatology communications · 2026Review
- Hepatocellular Carcinoma Risk Stratification for Cirrhosis Patients: Integrating Radiomics and Deep Learning Computed Tomography Signatures of the Liver and Spleen into a Clinical Model.Journal of clinical and translational hepatology · 2025Article
- Revealing New Trends in the Global Burden of Hepatocellular Cancer Related to Hepatitis C Virus by Region, Sociodemographic Index, and Sex.Journal of clinical medicine · 2025Article
- Patient-Perceived Risk of Hepatocellular Carcinoma and Net Benefit of Surveillance: A Multicenter Survey Study.The American journal of gastroenterology · 2025Article
- Health inequalities in hepatocellular carcinoma surveillance, diagnosis, treatment, and survival in the United Kingdom: a scoping review.BJC reports · 2025Article
- Integrating PNPLA3 into clinical risk prediction.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Risk factors for hepatocellular carcinoma in cirrhosis: A comprehensive analysis from a decade-long study.World journal of gastrointestinal oncology · 2024Review
- PNPLA3, Obesity, and Heavy Alcohol Use in Cirrhosis Patients May Exert a Synergistic Increase Hepatocellular Carcinoma Risk.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Article
- Differences in Prediagnostic Serum Metabolomic and Lipidomic Profiles Between Cirrhosis Patients with and without Incident Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2024Article
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsThe available risk stratification indices for hepatocellular cancer (HCC) have limited applicability. We developed and externally validated an HCC risk stratification index in U.S. cohorts of patients with cirrhosis.
methodsWe used data from 2 prospective U.S. cohorts to develop the risk index. Patients with cirrhosis were enrolled from 8 centers and followed until development of HCC, death, or December 31, 2021. We identified an optimal set of predictors with the highest discriminatory ability (C-index) for HCC. The predictors were refit using competing risk regression and its predictive performance was evaluated using the area under the receiver-operating characteristic curve (AUROC). External validation was performed in a cohort of 21,550 patients with cirrhosis seen in the U.S Veterans Affairs system between 2018 and 2019 with follow-up through 2021.
resultsWe developed the model in 2431 patients (mean age 60 years, 31% women, 24% cured hepatitis C, 16% alcoholic liver disease, and 29% nonalcoholic fatty liver disease). The selected model had a C-index of 0.77 (95% confidence interval [CI], 0.73-0.81), and the predictors were age, sex, smoking, alcohol use, body mass index, etiology, α-fetoprotein, albumin, alanine aminotransferase, and platelet levels. The AUROCs were 0.75 (95% CI, 0.65-0.85) at 1 year and 0.77 (95% CI, 0.71-0.83) at 2 years, and the model was well calibrated. In the external validation cohort, the AUROC at 2 years was 0.70 with excellent calibration.
conclusionThe risk index, including objective and routinely available risk factors, can differentiate patients with cirrhosis who will develop HCC and help guide discussions regarding HCC surveillance and prevention. Future studies are needed for additional external validation and refinement of risk stratification.
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