GES: A validated simple score to predict the risk of #HCC in patients with #HCV‐GT4‐associated advanced liver fibrosis after oral antivirals

Hepatocellular carcinoma (HCC) risk persists after hepatitis C virus (HCV) eradication with direct‐acting antivirals (DAAs), particularly in patients with cirrhosis. Identifying those who are likely to develop HCC is a critical unmet medical need. Our aim is to develop a score that offers individualized patient HCC risk prediction..

..In the derivation cohort, the median follow‐up was 23.51 ± 8.21 months, during which 109 patients (4.7%) developed HCC. Age, sex, serum albumin, α fetoprotein and pretreatment fibrosis stage were identified as risk factors for HCC. A simple predictive model (GES) score was constructed. The 2‐year cumulative HCC incidence using Kaplan‐Meier method was 1.2%, 3.3% and 7.1% in the low‐risk, medium‐risk and high‐risk groups respectively.

Internal and external validation showed highly significant difference among the three risk groups (P < .001) with regard to cumulative HCC risk. GES score has high predictive ability value (Harrell’s C statistic 0.801), that remained robustly consistent across two independent validation cohorts (Harrell’s C statistic 0.812 and 0.816).

GES score is simple with validated good predictive ability for the development of HCC after eradication of HCV and may be useful for HCC risk stratification in those patients