scholarly journals A Scoring System For Predicting Hepatocellular Carcinoma Risk In Alcoholic Cirrhosis: A Competing Risk Analysis

2021 ◽  
Author(s):  
Kyunghan Lee ◽  
Gwang Hyeon Choi ◽  
Eun Sun Jang ◽  
Sook-Hyang Jeong ◽  
Jin–Wook Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Analysis ◽  
Viral Hepatitis ◽  
Validation Cohort ◽  
Alcoholic Cirrhosis ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Hazards Model ◽  
B Virus

Abstract Background & Aims: The role of hepatocellular carcinoma (HCC) surveillance is being questioned in alcoholic cirrhosis because of the relative low HCC risk. Comorbid viral hepatitis may synergistically increase the HCC risk in alcoholic cirrhosis. This study aimed to assess the risk and predictors of HCC in patients with alcoholic cirrhosis by using competing risk analysis in an area with intermediate prevalence for hepatitis B virus.Methods: A total of 965 patients with alcoholic cirrhosis were recruited at a university-affiliated hospital in Korea and randomly assigned to either the derivation (n=643) and validation (n=322) cohort. Subdistribution hazards model of Fine and Gray was used with deaths and liver transplantation treated as competing risks. Death records were confirmed from Korean government databases. A nomogram was developed to calculate the Alcohol-associated Liver Cancer Estimation (ALICE) score.Results: Markers for viral hepatitis were positive in 21.0 % and 25.8 % of patients in derivation and validation cohort, respectively. The cumulative incidence of HCC was 13.5 and 14.9 % at 10 years for derivation and validation cohort, respectively. Age, positivity for viral hepatitis markers, alpha-fetoprotein level, and platelet count were identified as independent predictors of HCC and incorporated in the ALICE score, which discriminated low, intermediate, and high risk for HCC in alcoholic cirrhosis at the cut-off of 120 and 180. Conclusions: HCC risk can be stratified by using clinical parameters including viral markers in alcoholic cirrhosis in an area where the prevalence of viral hepatitis is substantial.

scholarly journals Risk Prediction of Hepatocellular Carcinoma in Patients With Alcoholic Cirrhosis in an Area With Intermediate Prevalence for Hepatitis B Virus Infection: a Competing Risk Analysis

2021 ◽  
Author(s):  
Kyunghan Lee ◽  
Gwang Hyeon Choi ◽  
Eun Sun Jang ◽  
Sook-Hyang Jeong ◽  
Jin-Wook Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Risk Analysis ◽  
Viral Hepatitis ◽  
Validation Cohort ◽  
Alcoholic Cirrhosis ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
B Virus

Abstract Background & Aims: The role of hepatocellular carcinoma (HCC) surveillance is being questioned in alcoholic cirrhosis because of the relative low incidence of HCC. Comorbid viral hepatitis may modify the risk, and competing outcomes may influence the actual incidence of HCC in alcoholic cirrhosis. This study aimed to assess the risk and predictors of HCC in patients with alcoholic cirrhosis by using competing risk analysis in an area with intermediate prevalence for hepatitis B virus.Methods: A total of 965 patients with alcoholic cirrhosis were recruited at a university-affiliated hospital in Korea and randomly assigned to either the derivation (n=643) and validation (n=322) cohort. Subdistribution hazards model of Fine and Gray was used with deaths and liver transplantation treated as competing risks. Death records were confirmed from Korean government databases. A nomogram was developed to calculate the Alcohol-associated Liver Cancer Estimation (ALICE) score.Results: Markers for viral hepatitis were positive in 21.0 % and 25.8 % of patients in derivation and validation cohort, respectively. The cumulative incidence of HCC was 13.5 and 14.9 % at 10 years for derivation and validation cohort, respectively. Age, positivity for viral hepatitis markers, alpha-fetoprotein level, and platelet count were identified as independent predictors of HCC and incorporated in the ALICE score, which discriminated low, intermediate, and high risk for HCC in alcoholic cirrhosis at the cut-off of 120 and 180. Conclusions: ALICE score reliably stratifies HCC risk of alcoholic cirrhosis in an area where the prevalence of viral hepatitis is substantial.

scholarly journals A Novel Competing Risk Analysis Model to Determine the Role of Cervical Lordosis in Bony and Ligamentous Injuries

2018 ◽  
Vol 119 ◽  
pp. e962-e967
Author(s):  
Narayan Yoganandan ◽  
Anjishnu Banerjee ◽  
Nicholas DeVogel ◽  
Frank A. Pintar ◽  
Jamie L. Baisden
Keyword(s):  
Risk Analysis ◽  
Competing Risk ◽  
Cervical Lordosis ◽  
Competing Risk Analysis ◽  
Analysis Model

scholarly journals The role of chemotherapy in patients with T1bN0M0 triple-negative breast cancer: a real-world competing risk analysis

2021 ◽  
Vol 12 (1) ◽  
pp. 10-17
Author(s):  
Tian Lan ◽  
Yunyan Lu ◽  
Hua Luo ◽  
Ouou Yang ◽  
Junling He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Analysis ◽  
Triple Negative Breast Cancer ◽  
Real World ◽  
Triple Negative ◽  
Competing Risk ◽  
Competing Risk Analysis

The prognostic role of body mass index on mortality amongst the middle-aged and elderly: A competing risk analysis

2014 ◽  
Vol 103 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Haleh Ghaem Maralani ◽  
Bee Choo Tai ◽  
Tien Y. Wong ◽  
E. Shyong Tai ◽  
Jialiang Li ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Risk Analysis ◽  
Body Mass ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Prognostic Role ◽  
Middle Aged

scholarly journals The Role of Adjuvant Chemotherapy in Metaplastic Breast Carcinoma: A Competing Risk Analysis of the SEER Database

2021 ◽  
Vol 11 ◽  
Author(s):  
Tian Lan ◽  
Yunyan Lu ◽  
Ruzhen Zheng ◽  
Xiying Shao ◽  
Hua Luo ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Risk Analysis ◽  
Selection Process ◽  
Treatment Strategies ◽  
Competing Risk ◽  
Lymph Node Status ◽  
Seer Database ◽  
Competing Risk Analysis ◽  
Metaplastic Breast Carcinoma

Purpose: Chemotherapy is the clinically recommended treatment for patients with operable metaplastic breast carcinoma (MBC); however, its impact remains controversial. This study investigated the possible role of chemotherapy in the treatment of MBC.Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify the operable MBC patients. The competing risk analysis along with the propensity score matching (PSM) method was performed to evaluate the effect of chemotherapy. Moreover, a competing risk nomogram was built to identify prognosis in patients with MBC.Results: Of the 1137 patients with MBC, 775 received chemotherapy and 362 did not receive chemotherapy. The 5-year cumulative incidence of breast cancer-specific death (BCSD) showed similar outcomes in both the Chemo and No-Chemo groups (21.1 vs. 24.3%, p = 0.57). Chemotherapy showed no apparent association with BCSD (HR, 1.07; 95% CI, 0.72–1.60; p = 0.72), even after subgroup analysis or PSM. Race, tumor size, lymph node status, and radiation were identified as the significant factors for MBC after a penalized variable selection process. In addition, a competing risk nomogram showed relatively good accuracy of prediction with a C-index of 0.766 (95% CI, 0.700–0.824).Conclusion: Our findings demonstrated that chemotherapy did not improve BCSD for operable MBC patients. Thus, it may indicate the need to reduce exposure to the current chemotherapy strategies for patients with resectable MBC. Additionally, some novel treatment strategies are required urgently to identify and target the potential biomarkers.

scholarly journals Competing risk analysis on outcome after hepatic resection of hepatocellular carcinoma in cirrhotic patients

2017 ◽  
Vol 23 (8) ◽  
pp. 1469 ◽  
Author(s):  
Alessandro Cucchetti ◽  
Carlo Sposito ◽  
Antonio Daniele Pinna ◽  
Davide Citterio ◽  
Matteo Cescon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Analysis ◽  
Hepatic Resection ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Cirrhotic Patients

scholarly journals Tenofovir Is Superior to Entecavir on Tertiary Prevention for BCLC Stage 0/A Hepatocellular Carcinoma after Curative Resection

Liver Cancer ◽  
2021 ◽  
pp. 1-16
Author(s):  
Ming-Chao Tsai ◽  
Chih-Chi Wang ◽  
Wei-Chen Lee ◽  
Chih-Che Lin ◽  
Kuo-Chin Chang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Risk Analysis ◽  
Lower Risk ◽  
Late Recurrence ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Risk Of Death ◽  
Hcc Recurrence ◽  
Curative Hepatectomy

<b><i>Background:</i></b> It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) have different effects on hepatocellular carcinoma (HCC) recurrence and death in patients receiving curative hepatectomy for hepatitis B virus (HBV)-related HCC. <b><i>Aims:</i></b> The aim of this study was to compare the long-term efficacy of ETV and TDF in HCC recurrence and overall survival (OS) of patients after curative hepatectomy. <b><i>Methods:</i></b> From January 2010 to December 2019, 20,572 patients with HCC who received hepatectomy were screened for study eligibility. Finally, a total of 219 consecutive patients treated with ETV (<i>n</i> = 146) or TDF (<i>n</i> = 73) after curative hepatectomy for HBV-related HCC of Barcelona Clinic Liver Cancer stage 0 or A were analyzed by propensity score matching (PSM) (2:1) analysis and competing risk analysis. HCC recurrence and OS of patients were compared between ETV and TDF groups. <b><i>Result:</i></b> After a median follow-up of 52.2 months, 81 patients (37.0%) had HCC recurrence, 33 (15.1%) died, and 5 (2.3%) received liver transplantation. TDF therapy was an independent protective factor for HCC recurrence compared with ETV therapy (HR, 1.687; 95% CI, 1.027–2.770, <i>p</i> = 0.039); however, no difference in the risk of death or liver transplantation. Results were similar in competing risk analysis. We further found that TDF therapy was significantly associated with a lower risk of late recurrence (HR, 4.705; 95% CI, 1.763–12.558, <i>p</i> = 0.002), but not in early recurrence. <b><i>Conclusions:</i></b> TDF therapy is associated with a significantly lower risk of HCC recurrence, especially of late recurrence, than ETV therapy among patients who undergo curative hepatectomy for HBV-related early-stage HCC.

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