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Related Experiment Video

Updated: Sep 16, 2025

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A Novel Risk Prediction Model for Hepatocellular Carcinoma in MASLD: A Multinational, Multicenter Cohort Study.

Ho Soo Chun1, Minjong Lee1, Hye Ah Lee2

  • 1Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Republic of Korea.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|July 11, 2025
PubMed
Summary

A new MASLD-HCC score identifies patients with metabolic dysfunction-associated steatotic liver disease at high risk for hepatocellular carcinoma. Key factors include obesity and diabetes, enabling better risk stratification for HCC development.

Keywords:
Cardiometabolic Risk FactorHepatocellular CarcinomaMetabolic Dysfunction–Associated Steatotic Liver DiseaseRisk Prediction Model

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Area of Science:

  • Hepatology and Gastroenterology
  • Metabolic Syndrome Research
  • Oncology and Cancer Risk Prediction

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing concern globally.
  • Identifying cardiometabolic risk factors (CMRFs) associated with hepatocellular carcinoma (HCC) in MASLD patients is crucial but unclear.
  • There is a need for a validated risk prediction model for HCC in MASLD.

Purpose of the Study:

  • To develop and validate a novel risk prediction model for HCC in MASLD patients.
  • To identify specific CMRFs significantly associated with HCC development in MASLD.
  • To enable physicians to stratify HCC risk among MASLD patients.

Main Methods:

  • A multicenter cohort study involving 77,677 MASLD patients across 20 medical centers in Asia and Western countries (2004-2023).
  • Development of the MASLD-HCC score using time-varying Cox multivariable analysis in a Korean training cohort (n=36,800).
  • Internal validation (n=36,799) and external validation (n=4078) in diverse Asian and Western populations.

Main Results:

  • Overweight/obesity (or central obesity) and prediabetes/diabetes were independently associated with HCC development in MASLD.
  • The developed MASLD-HCC score demonstrated strong predictive performance with a Harrell's C-index of 0.84 (training), 0.83 (internal validation), and 0.93 (external validation).
  • High-risk individuals identified by the MASLD-HCC score showed significantly elevated HCC development risk (sHR > 11 in training/internal, sHR > 56 in external validation).

Conclusions:

  • Overweight/obesity and prediabetes/diabetes are significant predictors of increased HCC risk in MASLD patients.
  • The novel MASLD-HCC score effectively stratifies HCC risk in MASLD.
  • This score can aid clinicians in identifying high-risk individuals for targeted surveillance and intervention.