ArticleDigestive diseases and sciences2026
Using the EVendo Score to Predict Varices and Varices Needing Treatment in Hepatocellular Carcinoma Patients Planned for Atezolizumab-Bevacizumab.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeAtezolizumab-Bevacizumab (AB) is first-line treatment for patients with hepatocellular carcinoma (HCC), and Bevacizumab is associated with increased gastrointestinal bleeding; hence IMBrave150 mandated esophago-gastroduodenoscopy (OGD) before therapy initiation. Universal pre-treatment OGD potentially delays treatment. Non-invasive scores have been developed to risk stratify patients for variceal screening to avoid unnecessary OGD. EVendo Score (ES) was developed with laboratory and clinical data, and demonstrated reliability in identifying patients with cirrhosis with gastroesophageal varices and varices needing treatment (VNT), but is not formally validated in patients with HCC. ES of
methodsWe retrospectively analysed data for 145 patients with HCC from National Cancer Centre (Singapore) and Asan Medical Centre (Korea) treated with AB from June 2018-July 2022 who underwent pre-treatment OGD. Biochemical data and clinical parameters were collected and ES calculated for each patient. Using pre-specified cut-offs, sensitivity, specificity, negative predictive value (NPV) and missed VNT rate were elucidated.
resultsES of
conclusionA low ES has high NPV for absence of VNT, but the NPV in our examined cohort is lower than previous validations, and there remains a significant missed VNT risk. Additional analysis should be performed with ES in conjunction with clinicoradiologic features before we can conclude its reliability as a screening tool. Further evaluation of cut-offs and application of this score in other populations should be explored.
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