ArticleClinical and molecular hepatology2025
High Steatosis-Associated Fibrosis Estimator scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction-associated steatotic liver disease.
Article in Clinical and molecular hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Absence of steatosis combined with cardiometabolic risk factors confers the highest hepatocellular carcinoma risk in treated chronic hepatitis B.Annals of medicine · 2026Article
- Differential Cancer Risks and Noninvasive Predictors in MASLD, MetALD, and ALD: A Longitudinal Analysis.Gut and liver · 2026Article
- Risk of HCC in Elderly Patients With MASLD: Proposal of an Effective Surveillance Strategy.Journal of gastroenterology and hepatology · 2026Article
- Predictive modeling and clinical decision tools for risk stratification in steatotic liver disease.Clinical and molecular hepatology · 2026Review
- Predictors of Discordance Between Controlled Attenuation Parameter and Magnetic Resonance-Proton Density Fat Fraction in Hepatic Steatosis.Clinical and translational gastroenterology · 2026Article
- SAFE score in chronic liver diseases: A tool for risk enrichment and personalized surveillance: Correspondence to letter to the editor on "High Steatosis-Associated Fibrosis Estimator scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction-associated steatotic liver disease".Clinical and molecular hepatology · 2026Article
- Association of noninvasive liver fibrosis scores with severity and outcomes among individuals with cardiovascular-kidney-metabolic syndrome: evidence from the NHANES 2005-2018.BMC cardiovascular disorders · 2026Article
- Letter to the editor on "High Steatosis-Associated Fibrosis Estimator scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction-associated steatotic liver disease".Clinical and molecular hepatology · 2026Article
- HCC predictors in routine practice for patients with chronic liver diseases: Correspondence to editorial on "High SAFE scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction associated steatotic liver disease".Clinical and molecular hepatology · 2026Article
- Risk stratification for hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease: Editorial on "High Steatosis-Associated Fibrosis Estimator scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction-associated steatotic liver disease".Clinical and molecular hepatology · 2026Article
- Can SAFE score be utilized as a universal hepatocellular carcinoma prediction score?: Editorial on "High Steatosis-Associated Fibrosis Estimator scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction-associated steatotic liver disease".Clinical and molecular hepatology · 2026Article
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13 authors.
Funding
Abstract
BACKGROUND/
aimsThere are no hepatocellular carcinoma (HCC) surveillance recommendations for non-viral chronic liver diseases (CLD), such as metabolic dysfunction-associated steatotic liver disease (MASLD). We explored the Steatosis-Associated Fibrosis Estimator (SAFE) score to predict HCC in MASLD and other CLD etiologies.
methodsPatients with various CLDs were included from medical centers in Taiwan. The SAFE score, consisting of age, body mass index, diabetes, and laboratory data, was calculated at baseline, and patients were traced for new development of HCC. The predictability of the SAFE score for HCC was analyzed using the sub-distribution hazard model with adjustments for competing risks.
resultsAmong 12,963 CLD patients with a median follow-up of 4 years, 258 developed HCC. The SAFE score classifies 1-, 3-, and 5-year HCC risk regardless of CLD etiologies. High (≥100) and intermediate (0-100) SAFE scores increased 11 and 2 folds HCC risks compared to low (<0) SAFE scores. Combining two lower risk tiers (SAFE<100), a high SAFE score (≥100) was associated with a 7.5-fold risk of HCC (adjusted sub-distributional hazard ratio [aSHR] 7.54; 95% confidence interval (CI) 5.38-10.60). A high SAFE score increased the risks of HCC in subgroups of viral hepatitis, non-viral hepatitis (aSHR 11.10; 95% CI 3.97-31.30) and MASLD (aSHR 4.23; 95% CI 1.43-12.50). A hospital cohort (n=8,103) and a community MASLD cohort (n=120,166) validated the high SAFE score (≥100) for HCC risk prediction.
conclusionThe SAFE score stratifies high risks for HCC in CLD patients regardless of etiologies and helps to select at-risk candidates for HCC surveillance.
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