File Download
 
Links for fulltext
(May Require Subscription)
 
Supplementary

Article: Risk estimation for hepatocellular carcinoma in chronic hepatitis B (REACH-B): Development and validation of a predictive score
  • Basic View
  • Metadata View
  • XML View
TitleRisk estimation for hepatocellular carcinoma in chronic hepatitis B (REACH-B): Development and validation of a predictive score
 
AuthorsYang, HI1 4
Yuen, MF3
Chan, HLY6
Han, KH5
Chen, PJ2
Kim, DY5
Ahn, SH5
Chen, CJ1 2
Wong, VWS6
Seto, WK3
 
Issue Date2011
 
PublisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/j.lancetoncol
 
CitationThe Lancet Oncology, 2011, v. 12 n. 6, p. 568-574 [How to Cite?]
DOI: http://dx.doi.org/10.1016/S1470-2045(11)70077-8
 
AbstractBackground: Therapy for chronic hepatitis B reduces the risk of progressing to hepatocellular carcinoma (HCC); however, there is no suitable and accurate means to assess risk. This study aimed to develop and validate a simple scoring system to predict HCC risk in patients with chronic hepatitis B. Methods: The development cohort consisted of 3584 patients without cirrhosis from the community-based Taiwanese REVEAL-HBV study (of whom 131 developed HCC during follow-up), and a validation cohort of 1505 patients from three hospitals in Hong Kong and South Korea (of whom 111 developed HCC during follow-up). We used Cox multivariate proportional hazards model to predict risk of HCC at 3, 5, and 10 years. Variables included in the risk score were sex, age, serum alanine aminotransferase concentration, HBeAg status, and serum HBV DNA level. We calculated the area under receiver operating curve (AUROC) and calibration of predicted and observed HCC risk. Findings: A 17-point risk score was developed, with HCC risk ranging from 0·0% to 23·6% at 3 years, 0·0% to 47·4% at 5 years, and 0·0% to 81·6% at 10 years for patients with the lowest and highest HCC risk, respectively. AUROCs to predict risk were 0·811 (95% CI 0·790-0·831) at 3 years, 0·796 (0·775-0·816) at 5 years, and 0·769 (0·747-0·790) at 10 years in the validation cohort, and 0·902 (0·884-0·918), 0·783 (0·759-0·806), and 0·806 (0·783-0·828), respectively, after exclusion of 277 patients in the validation cohort with cirrhosis. Predicted risk was well calibrated with Kaplan-Meier observed HCC risk. Interpretation: A simple-to-use risk score that uses baseline clinical variables was developed and validated. The score accurately estimates the risk of developing HCC at 3, 5, and 10 years in patients with chronic hepatitis B. Clinicians can use this score to assess risk of HCC in patients with chronic hepatitis B and subsequently make evidence-based decisions about their clinical management. Funding: The Academia Sinica; the National Health Research Institute, Taiwan; and Bristol-Myers Squibb. © 2011 Elsevier Ltd.
 
ISSN1470-2045
2012 Impact Factor: 25.117
2012 SCImago Journal Rankings: 9.928
 
DOIhttp://dx.doi.org/10.1016/S1470-2045(11)70077-8
 
ISI Accession Number IDWOS:000291842400020
Funding AgencyGrant Number
Academia Sinica
National Health Research Institute, Taiwan
Bristol-Myers Squibb
Bristol-Myers Squibb (Singapore)
Department of Health, Executive Yuan, Taipei, Taiwan
Academia Sinica, Taipei, Taiwan
National Health Research Institute, Chunan, Taiwan
Bristol-Myers Squibb (Wallingford, CT, USA)
Funding Information:

The Academia Sinica; the National Health Research Institute, Taiwan; and Bristol-Myers Squibb.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorYang, HI
 
dc.contributor.authorYuen, MF
 
dc.contributor.authorChan, HLY
 
dc.contributor.authorHan, KH
 
dc.contributor.authorChen, PJ
 
dc.contributor.authorKim, DY
 
dc.contributor.authorAhn, SH
 
dc.contributor.authorChen, CJ
 
dc.contributor.authorWong, VWS
 
dc.contributor.authorSeto, WK
 
dc.date.accessioned2011-08-26T14:24:07Z
 
dc.date.available2011-08-26T14:24:07Z
 
dc.date.issued2011
 
dc.description.abstractBackground: Therapy for chronic hepatitis B reduces the risk of progressing to hepatocellular carcinoma (HCC); however, there is no suitable and accurate means to assess risk. This study aimed to develop and validate a simple scoring system to predict HCC risk in patients with chronic hepatitis B. Methods: The development cohort consisted of 3584 patients without cirrhosis from the community-based Taiwanese REVEAL-HBV study (of whom 131 developed HCC during follow-up), and a validation cohort of 1505 patients from three hospitals in Hong Kong and South Korea (of whom 111 developed HCC during follow-up). We used Cox multivariate proportional hazards model to predict risk of HCC at 3, 5, and 10 years. Variables included in the risk score were sex, age, serum alanine aminotransferase concentration, HBeAg status, and serum HBV DNA level. We calculated the area under receiver operating curve (AUROC) and calibration of predicted and observed HCC risk. Findings: A 17-point risk score was developed, with HCC risk ranging from 0·0% to 23·6% at 3 years, 0·0% to 47·4% at 5 years, and 0·0% to 81·6% at 10 years for patients with the lowest and highest HCC risk, respectively. AUROCs to predict risk were 0·811 (95% CI 0·790-0·831) at 3 years, 0·796 (0·775-0·816) at 5 years, and 0·769 (0·747-0·790) at 10 years in the validation cohort, and 0·902 (0·884-0·918), 0·783 (0·759-0·806), and 0·806 (0·783-0·828), respectively, after exclusion of 277 patients in the validation cohort with cirrhosis. Predicted risk was well calibrated with Kaplan-Meier observed HCC risk. Interpretation: A simple-to-use risk score that uses baseline clinical variables was developed and validated. The score accurately estimates the risk of developing HCC at 3, 5, and 10 years in patients with chronic hepatitis B. Clinicians can use this score to assess risk of HCC in patients with chronic hepatitis B and subsequently make evidence-based decisions about their clinical management. Funding: The Academia Sinica; the National Health Research Institute, Taiwan; and Bristol-Myers Squibb. © 2011 Elsevier Ltd.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationThe Lancet Oncology, 2011, v. 12 n. 6, p. 568-574 [How to Cite?]
DOI: http://dx.doi.org/10.1016/S1470-2045(11)70077-8
 
dc.identifier.citeulike9195602
 
dc.identifier.doihttp://dx.doi.org/10.1016/S1470-2045(11)70077-8
 
dc.identifier.epage574
 
dc.identifier.hkuros189829
 
dc.identifier.hkuros213689
 
dc.identifier.isiWOS:000291842400020
Funding AgencyGrant Number
Academia Sinica
National Health Research Institute, Taiwan
Bristol-Myers Squibb
Bristol-Myers Squibb (Singapore)
Department of Health, Executive Yuan, Taipei, Taiwan
Academia Sinica, Taipei, Taiwan
National Health Research Institute, Chunan, Taiwan
Bristol-Myers Squibb (Wallingford, CT, USA)
Funding Information:

The Academia Sinica; the National Health Research Institute, Taiwan; and Bristol-Myers Squibb.

 
dc.identifier.issn1470-2045
2012 Impact Factor: 25.117
2012 SCImago Journal Rankings: 9.928
 
dc.identifier.issue6
 
dc.identifier.pmid21497551
 
dc.identifier.scopuseid_2-s2.0-79957448464
 
dc.identifier.spage568
 
dc.identifier.urihttp://hdl.handle.net/10722/137376
 
dc.identifier.volume12
 
dc.languageeng
 
dc.publisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/j.lancetoncol
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofThe Lancet Oncology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshCarcinoma, Hepatocellular - etiology
 
dc.subject.meshHepatitis B, Chronic - complications
 
dc.subject.meshLiver Neoplasms - etiology
 
dc.subject.meshProportional Hazards Models
 
dc.subject.meshROC Curve
 
dc.titleRisk estimation for hepatocellular carcinoma in chronic hepatitis B (REACH-B): Development and validation of a predictive score
 
dc.typeArticle
 
<?xml encoding="utf-8" version="1.0"?>
<item><contributor.author>Yang, HI</contributor.author>
<contributor.author>Yuen, MF</contributor.author>
<contributor.author>Chan, HLY</contributor.author>
<contributor.author>Han, KH</contributor.author>
<contributor.author>Chen, PJ</contributor.author>
<contributor.author>Kim, DY</contributor.author>
<contributor.author>Ahn, SH</contributor.author>
<contributor.author>Chen, CJ</contributor.author>
<contributor.author>Wong, VWS</contributor.author>
<contributor.author>Seto, WK</contributor.author>
<date.accessioned>2011-08-26T14:24:07Z</date.accessioned>
<date.available>2011-08-26T14:24:07Z</date.available>
<date.issued>2011</date.issued>
<identifier.citation>The Lancet Oncology, 2011, v. 12 n. 6, p. 568-574</identifier.citation>
<identifier.issn>1470-2045</identifier.issn>
<identifier.uri>http://hdl.handle.net/10722/137376</identifier.uri>
<description.abstract>Background: Therapy for chronic hepatitis B reduces the risk of progressing to hepatocellular carcinoma (HCC); however, there is no suitable and accurate means to assess risk. This study aimed to develop and validate a simple scoring system to predict HCC risk in patients with chronic hepatitis B. Methods: The development cohort consisted of 3584 patients without cirrhosis from the community-based Taiwanese REVEAL-HBV study (of whom 131 developed HCC during follow-up), and a validation cohort of 1505 patients from three hospitals in Hong Kong and South Korea (of whom 111 developed HCC during follow-up). We used Cox multivariate proportional hazards model to predict risk of HCC at 3, 5, and 10 years. Variables included in the risk score were sex, age, serum alanine aminotransferase concentration, HBeAg status, and serum HBV DNA level. We calculated the area under receiver operating curve (AUROC) and calibration of predicted and observed HCC risk. Findings: A 17-point risk score was developed, with HCC risk ranging from 0&#183;0% to 23&#183;6% at 3 years, 0&#183;0% to 47&#183;4% at 5 years, and 0&#183;0% to 81&#183;6% at 10 years for patients with the lowest and highest HCC risk, respectively. AUROCs to predict risk were 0&#183;811 (95% CI 0&#183;790-0&#183;831) at 3 years, 0&#183;796 (0&#183;775-0&#183;816) at 5 years, and 0&#183;769 (0&#183;747-0&#183;790) at 10 years in the validation cohort, and 0&#183;902 (0&#183;884-0&#183;918), 0&#183;783 (0&#183;759-0&#183;806), and 0&#183;806 (0&#183;783-0&#183;828), respectively, after exclusion of 277 patients in the validation cohort with cirrhosis. Predicted risk was well calibrated with Kaplan-Meier observed HCC risk. Interpretation: A simple-to-use risk score that uses baseline clinical variables was developed and validated. The score accurately estimates the risk of developing HCC at 3, 5, and 10 years in patients with chronic hepatitis B. Clinicians can use this score to assess risk of HCC in patients with chronic hepatitis B and subsequently make evidence-based decisions about their clinical management. Funding: The Academia Sinica; the National Health Research Institute, Taiwan; and Bristol-Myers Squibb. &#169; 2011 Elsevier Ltd.</description.abstract>
<language>eng</language>
<publisher>The Lancet Publishing Group. The Journal&apos;s web site is located at http://www.elsevier.com/locate/j.lancetoncol</publisher>
<relation.ispartof>The Lancet Oncology</relation.ispartof>
<subject.mesh>Carcinoma, Hepatocellular - etiology</subject.mesh>
<subject.mesh>Hepatitis B, Chronic - complications</subject.mesh>
<subject.mesh>Liver Neoplasms - etiology</subject.mesh>
<subject.mesh>Proportional Hazards Models</subject.mesh>
<subject.mesh>ROC Curve</subject.mesh>
<title>Risk estimation for hepatocellular carcinoma in chronic hepatitis B (REACH-B): Development and validation of a predictive score</title>
<type>Article</type>
<description.nature>Link_to_subscribed_fulltext</description.nature>
<identifier.doi>10.1016/S1470-2045(11)70077-8</identifier.doi>
<identifier.pmid>21497551</identifier.pmid>
<identifier.scopus>eid_2-s2.0-79957448464</identifier.scopus>
<identifier.hkuros>189829</identifier.hkuros>
<identifier.hkuros>213689</identifier.hkuros>
<relation.references>http://www.scopus.com/mlt/select.url?eid=2-s2.0-79957448464&amp;selection=ref&amp;src=s&amp;origin=recordpage</relation.references>
<identifier.volume>12</identifier.volume>
<identifier.issue>6</identifier.issue>
<identifier.spage>568</identifier.spage>
<identifier.epage>574</identifier.epage>
<identifier.isi>WOS:000291842400020</identifier.isi>
<publisher.place>United Kingdom</publisher.place>
<identifier.citeulike>9195602</identifier.citeulike>
</item>
Author Affiliations
  1. Academia Sinica Taiwan
  2. National Taiwan University
  3. The University of Hong Kong
  4. China Medical University Hospital Taichung
  5. Yonsei University College of Medicine
  6. Chinese University of Hong Kong