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HCC Risk Scores: Useful or Not?

Morris Sherman¹

¹Department of Medicine, University Health Network, Toronto, Ontario, Canada.

Seminars in Liver Disease

|December 23, 2017

Summary

New risk scores help identify individuals needing hepatocellular carcinoma (HCC) surveillance, improving resource allocation. While useful, their long-term performance and correlation with HCC risk require further assessment.

Area of Science:

Hepatology
Oncology
Medical Diagnostics

Background:

Hepatocellular carcinoma (HCC) surveillance is crucial but resource-intensive.
Current surveillance strategies often include broad populations (e.g., all hepatitis B or cirrhosis patients) leading to overuse.
Refining risk assessment is necessary to optimize surveillance for hepatocellular carcinoma.

Purpose of the Study:

To evaluate the utility of various risk-scoring models for hepatocellular carcinoma (HCC).
To determine the effectiveness of new models in identifying individuals at high risk for HCC.
To assess the generalizability and validation of existing HCC risk prediction tools.

Main Methods:

Review and analysis of existing risk stratification models for HCC.

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Comparison of different models developed for specific conditions (hepatitis B, hepatitis C, cirrhosis) and the general population.

Assessment of model generalizability and external validation status.

Main Results:

Multiple risk-scoring models have been developed for diverse patient groups, including those with hepatitis B, hepatitis C, and cirrhosis.
Some models demonstrate better risk identification than broad screening criteria.
Many models lack external validation, and few specify the threshold for initiating surveillance.

Conclusions:

Risk-scoring models offer improved guidance for hepatocellular carcinoma (HCC) surveillance, helping to exclude low-risk individuals.
Further research is needed to assess the long-term performance and correlation of risk scores with actual HCC development.
Enhanced validation and standardization of HCC risk assessment tools are essential for clinical practice.