RT Journal Article
T1 A Model Based on Noninvasive Markers Predicts Very Low Hepatocellular Carcinoma Risk After Viral Response in Hepatitis C Virus-Advanced Fibrosis
A1 Alonso López, S
A1 Devesa Medina, María José
A1 Izquierdo Rubio, Sonia
A1 Rincón Rodríguez, Diego
A1 Bañares Cañizares, Rafael
AB virus (HCV) and advanced fibrosis remain at risk of hepatocellularcarcinoma (HCC) after sustained viral response(SVR) and need lifelong surveillance. Because HCC risk isnot homogenous and may decrease with fibrosis regression, weaimed to identify patients with low HCC risk based on theprediction of noninvasive markers and its changes after SVR.APP ROA CH AND RESULT S: This is a multicenter cohortstudy, including patients with HCV and compensated advancedfibrosis that achieved SVR after direct antivirals. Clinical andtransient elastography (TE) data were registered at baseline,1 year, and 3 years after the end of treatment (EOT). Allpatients underwent liver ultrasound scan every 6 months.Patients with clinical evaluation 1 year after EOT were eligible.Univariate and multivariate Cox regression analysis wereperformed, and predictive models were constructed. HCC occurrencerates were evaluated by Kaplan-Meier. Nine hundredand ninety-three patients were eligible (56% male; 44%female; median age 62 years), 35 developed HCC (3.9%),and the median follow-up was 45 months (range 13-53).Baseline liver stiffness measurement (LSM) (HR 1.040; 95%CI 1.017-1.064), serum albumin (HR 0.400; 95% CI 0.174-0.923), 1-year DeltaLSM (HR 0.993; 95% CI 0.987-0.998),and 1-year FIB-4 score (HR 1.095; 95% CI 1.046-1.146)were independent factors associated with HCC. The TE-basedHCC risk model predicted 0% of HCC occurrence at 3 yearsin patients with score 0 (baseline LSM ≤ 17.3 kPa, albumin>4.2 g/dL, and 1-year DeltaLSM > 25.5%) versus 5.2% in patientswith score 1-3 (Harrell’s C 0.779; log-rank 0.002). Analternative model with FIB-4 similarly predicted HCC risk.CONCLUSIONS: A combination of baseline and dynamicchanges in noninvasive markers may help to identify patientswith a very low risk of HCC development after SVR.
PB Lippincott, Williams & Wilkins
SN 0270-9139
YR 2020
FD 2020-11-01
LK https://hdl.handle.net/20.500.14352/98654
UL https://hdl.handle.net/20.500.14352/98654
LA eng
NO Alonso López S, Manzano ML, Gea F, Gutiérrez ML, Ahumada AM, Devesa MJ, Olveira A, Polo BA, Márquez L, Fernández I, Cobo JCR, Rayón L, Riado D, Izquierdo S, Usón C, Real Y, Rincón D, Fernández-Rodríguez CM, Bañares R. A Model Based on Noninvasive Markers Predicts Very Low Hepatocellular Carcinoma Risk After Viral Response in Hepatitis C Virus-Advanced Fibrosis. Hepatology. 2020 Dec;72(6):1924-1934. doi: 10.1002/hep.31588. Epub 2020 Nov 10. PMID: 33022803.
NO En este estudio se describe un modelo de predicción del riesgo de desarrollar hepatocarcinoma en pacientes con enfermedad hepática avanzada por virus C tras alcanzar la curación virológica. Se demuestra en el estudio que variables de fácil obtención (FIB-4, elastografía) que evalúan el grado de rigidez hepática y su dinámica influyen en el riesgo de desarrollar cáncer hepático. Se trata de un estudio multicéntrico coordinado desde el grupo del solicitante que pretende responder a una pregunta clave con claras connotaciones relacionadas con la práctica clínica. Además de su publicación en una revista de primer decil, este artículo ha supuesto el desarrollo de una colaboración multinacional que ha dado lugar a diversoss artículos posteriores.
DS Docta Complutense
RD 1 ene 2026