title: Nomogram for individualized prediction of hepatocellular carcinoma occurrence in hepatitis C virus cirrhosis (ANRS CO12 CirVir).
abstract: 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.
  
  
  
  This HCC score can accurately predict HCC at an individual level in French patients with HCV cirrhosis. (Hepatology 2016;64:1136-1147).
authors.affiliation: AP-HP, Hospital Jean Verdier, Liver Unit, Bondy, France. nathalie.ganne@jvr.aphp.fr.|University Paris 13, Sorbonne Paris Cité, Paris, France. nathalie.ganne@jvr.aphp.fr.|Inserm, UMR-1162 "Genomic alterations in liver tumors", F-75010, Paris, France. nathalie.ganne@jvr.aphp.fr.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Ganne-Carrié
authors.affiliation: AP-HP, Hospital Henri Mondor, Department of Public Health, Créteil, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Layese
authors.affiliation: AP-HP, Hospital Jean Verdier, Liver Unit, Bondy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Bourcier
authors.affiliation: Unit for Basic and Clinical research on Viral Hepatitis, ANRS (France REcherche Nord & Sud Sida-HIV Hépatites-FRENSH), Paris, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Cagnot
authors.affiliation: AP-HP, Hospital Beaujon, Liver Unit, Clichy and University Paris 7, Paris, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Marcellin
authors.affiliation: University Hospital Pontchaillou, Liver Unit, Rennes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Guyader
authors.affiliation: University Paris Descartes, APHP, Liver Unit, Hospital Cochin; INSERM U-818 and USM20, Institut Pasteur, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.affiliation: Hospital Saint Eloi, Liver Unit, Montpellier, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Larrey
authors.affiliation: Hospital Haut-Lévêque, Liver Unit, Bordeaux, France.
authors.forename: Victor
authors.initials: V
authors.lastname: de Lédinghen
authors.affiliation: Institut Arnaud Tzanck, Liver Unit, St. Laurent du Var, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Ouzan
authors.affiliation: Hospices Civils de Lyon, Liver Unit, University and INSERM U1052, Lyon, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Zoulim
authors.affiliation: University Paris 13, Sorbonne Paris Cité, Paris, France.|AP-HP, Hospital Avicenne, Liver Unit, Bobigny, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Roulot
authors.affiliation: University Hospital of Nice, Liver Unit, F-06202, Cedex 3, Nice; Inserm U1065, C3M, Team 8, "Hepatic Complications in Obesity," F-06204, Cedex 3, Nice, France.
authors.forename: Albert
authors.initials: A
authors.lastname: Tran
authors.affiliation: Inserm 954, Universitary Hospital of Nancy, University of Lorraine, Vandoeuvre-les-Nancy, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bronowicki
authors.affiliation: Clinic of Hepato-Gastroenterology, Digidune pole, University Hospital, Grenoble, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Zarski
authors.affiliation: Hospital Charles-Nicolle, Liver Unit, Rouen, France.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Riachi
authors.affiliation: University Hospital, Liver Unit and University Bretagne-Loire, Angers, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Calès
authors.affiliation: Hospital Purpan, Liver Unit and University Paul Sabatier III, Toulouse, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Péron
authors.affiliation: University Hospital, Internal Medicine Unit - Digestive pole UMR 152, Toulouse, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.affiliation: Hospital Saint Joseph, Liver Unit, Marseille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bourlière
authors.affiliation: Hospital Claude Huriez, Liver Unit, Lille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Mathurin
authors.affiliation: Hospital St André, Liver Unit, Bordeaux, France.
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Blanc
authors.affiliation: Hospital Hôtel Dieu, Liver Unit, Clermont-Ferrand, France.
authors.forename: Armand
authors.initials: A
authors.lastname: Abergel
authors.affiliation: AP-HP, Hospital Saint-Antoine, Liver Unit, Paris.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Serfaty
authors.affiliation: AP-HP, Hospital Henri Mondor, Liver Unit, Créteil, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Mallat
authors.affiliation: AP-HP, Hospital Tenon, Liver Unit, Paris, France.
authors.forename: Jean-Didier
authors.initials: JD
authors.lastname: Grangé
authors.affiliation: AP-HP, Hospital Paul Brousse, Liver Unit, Villejuif, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Attali
authors.affiliation: Hospital Trousseau, Liver Unit, Tours, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Bacq
authors.affiliation: Hospital of Aix-En-Provence, Liver Unit, Aix-En-Provence, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Wartelle
authors.affiliation: Hospital Côte de Nacre, Liver Unit, Caen, France.
authors.forename: Thông
authors.initials: T
authors.lastname: Dao
authors.affiliation: AP-HP, Pitié-Salpêtrière Hospital, Liver Unit, Paris, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Benhamou
authors.affiliation: General Hospital, Liver Unit, Le Mans, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Pilette
authors.affiliation: University Hospital, Liver Unit, Poitiers, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Silvain
authors.affiliation: Institut Mutualiste Montsouris, Liver Unit, Paris, France.
authors.forename: Christos
authors.initials: C
authors.lastname: Christidis
authors.affiliation: University Hospital Amiens Nord, Liver Unit, Amiens, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Capron
authors.affiliation: University Hospital Robert Debré, Liver Unit, Reims, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bernard-Chabert
authors.affiliation: Hospital Foch, Internal Medicine, Suresnes, France.
authors.forename: David
authors.initials: D
authors.lastname: Zucman
authors.affiliation: University Hospital Jean Minjoz, Liver Unit, Besançon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Di Martino
authors.affiliation: AP-HP, Hospital Jean Verdier, Liver Unit, Bondy, France.|University Paris 13, Sorbonne Paris Cité, Paris, France.|Inserm, UMR-1162 "Genomic alterations in liver tumors", F-75010, Paris, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Trinchet
authors.affiliation: AP-HP, Hospital Jean Verdier, Liver Unit, Bondy, France.|University Paris 13, Sorbonne Paris Cité, Paris, France.|Inserm, UMR-1162 "Genomic alterations in liver tumors", F-75010, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Nahon
authors.affiliation: AP-HP, Hospital Henri Mondor, Department of Public Health, Créteil, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Roudot-Thoraval
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D011446:Prospective Studies