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Nomogram for individualized prediction of hepatocellular carcinoma occurrence in hepatitis C virus cirrhosis (ANRS CO12 CirVir)

Nathalie Ganne-Carrié 1, 2 Richard Layese 3 Valérie Bourcier 2 Carole Cagnot 4 Patrick Marcellin 5 Dominique Guyader 6 Stanislas Pol 7, 8 Dominique Larrey 9 Victor De Lédinghen 10 Denis Ouzan 11 Fabien Zoulim 12, 13 Dominique Roulot 14 Albert Tran 15, 16 Jean-Pierre Bronowicki 17 Jean-Pierre Zarski 18 Ghassan Riachi 19 Paul Calès 20 Jean-Marie Péron 21 Laurent Alric 22 Marc Bourlière 23 Philippe Mathurin 24 Jean-Frédéric Blanc 25 Armand Abergel 26 Lawrence Serfaty 27 Ariane Mallat 28 Jean-Didier Grangé 29 Pierre Attali 30 Yannick Bacq 31 Claire Wartelle 32 Thông Dao 33 Yves Benhamou 34 Christophe Pilette 35 Christine Silvain 36 Christos Christidis 37 Dominique Capron 38 Brigitte Bernard-Chabert 39 David Zucman 40 Vincent Di Martino Jean-Claude Trinchet 1, 2 Pierre Nahon 1, 2 Françoise Roudot-Thoraval 3
Abstract : Unlabelled - The aim of this work was to develop an individualized score for predicting hepatocellular carcinoma (HCC) in patients with hepatitis C (HCV)-compensated cirrhosis. Among 1,323 patients with HCV cirrhosis enrolled in the French prospective ANRS CO12 CirVir cohort, 720 and 360 were randomly assigned to training and validation sets, respectively. Cox's multivariate model was used to predict HCC, after which a nomogram was computed to assess individualized risk. During follow-up (median, 51.0 months), 103 and 39 patients developed HCC in the training and validation sets, respectively. Five variables were independently associated with occurrence of HCC: age > 50 years (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.16; 3.25; P = 0.012); past excessive alcohol intake (HR, 1.55; 95% CI, 1.02; 2.36; P = 0.041); low platelet count (<100 Giga/mm(3) : HR, 2.70; 95% CI, 1.62; 4.51; P < 0.001; [100; 150] Giga/mm(3) : HR, 1.87; 95% CI, 1.10; 3.18; P = 0.021); gamma-glutamyl transpeptidase above the upper limit of normal (HR, 1.96; 95% CI, 1.11; 3.47; P = 0.021); and absence of a sustained virological response during follow-up (HR, 3.02; 95% CI, 1.67; 5.48; P < 0.001). An 11-point risk score was derived from the training cohort and validated in the validation set. Based on this score, the population was stratified into three groups, in which HCC development gradually increased, from 0% to 30.1% at 5 years for patients with the lowest (≤3) and highest (≥8) scores (P < 0.001). Using this score, a nomogram was built enabling individualized prediction of HCC occurrence at 1, 3, and 5 years. Conclusion - This HCC score can accurately predict HCC at an individual level in French patients with HCV cirrhosis. (Hepatology 2016;64:1136-1147).
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Nathalie Ganne-Carrié, Richard Layese, Valérie Bourcier, Carole Cagnot, Patrick Marcellin, et al.. Nomogram for individualized prediction of hepatocellular carcinoma occurrence in hepatitis C virus cirrhosis (ANRS CO12 CirVir). Hepatology, Wiley-Blackwell, 2016, 64 (4), pp.1136-1147. ⟨10.1002/hep.28702⟩. ⟨hal-01381662⟩

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