Chun, Ho Soo;
Lee, Minjong;
Lee, Hye Ah;
Park, Eun Seo;
Choi, Jeong Yoon;
Baek, Hyo Song;
Kim, Tae Hun;
... Kim, Seung Up; + view all
(2025)
A novel risk prediction model for hepatocellular carcinoma in MASLD: A multinational, multicenter cohort study.
Clin Gastroenterol Hepatol
10.1016/j.cgh.2025.06.025.
(In press).
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CGH_2025-07.pdf - Accepted Version Access restricted to UCL open access staff until 11 July 2026. Download (9MB) |
Abstract
Background and aims: It is unclear that which cardiometabolic risk factors (CMRFs) are significantly associated with hepatocellular carcinoma (HCC) development in metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to develop and validate a novel CMRF-based HCC risk prediction model in MASLD. / / Methods: This multicenter cohort study recruited 77,677 MASLD patients from 20 medical centers in Korea and other Asian and Western countries (2004–2023). A novel CMRF-based HCC risk prediction model (MASLD-HCC score) was developed based on time-varying Cox multivariable analysis in a training cohort (n=36,800, Korea), which was validated internally (n=36,799, Korea) and externally (n=4,078, 11 other Asia and Western countries). / / Results: In the training cohort, 71 (0.2%) patients developed HCC (median follow-up, 5.1 years). Overweight/obesity or central obesity and pre-diabetes/diabetes were independently associated with HCC development, along with age, sex, and platelets. MASLD-HCC score with these five risk factors showed a Harrell’s C-index of 0.84 for HCC development, which was maintained in the internal (C-index 0.83) and external validation cohorts (C-index 0.93), and the model was well calibrated. Decision curve analyses showed that patients had positive net benefits from the model. When stratified by the MASLD-HCC score, the risk of HCC development in high-risk group was significantly higher than low-risk group (training: sub-distribution hazard ratio [sHR]=11.44, 95% confidence interval [CI]= 7.10–18.41; internal validation: sHR=12.36, 95% CI=7.72–19.79; external validation: sHR=56.84, 95% CI=12.88–250.73; all P<0.001). / / Conclusion: Overweight/obesity or central obesity and pre-diabetes/diabetes with fibrotic burden were significantly associated with the increased HCC risk in MASLD. The MASLD-HCC score may enable physicians to stratify the HCC risk.
| Type: | Article |
|---|---|
| Title: | A novel risk prediction model for hepatocellular carcinoma in MASLD: A multinational, multicenter cohort study |
| Location: | United States |
| DOI: | 10.1016/j.cgh.2025.06.025 |
| Publisher version: | https://doi.org/10.1016/j.cgh.2025.06.025 |
| Language: | English |
| Additional information: | This version is the author-accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Metabolic dysfunction-associated steatotic liver disease, cardiometabolic risk factor, hepatocellular carcinoma, risk prediction model |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10211838 |
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