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CAGE-B and SAGE-B models better predict the hepatitis B virus-related hepatocellular carcinoma after 5-year entecavir treatment than PAGE-B

 Hye Yeon Chon  ;  Han Ah Lee  ;  Soo Young Park  ;  Yeon Seok Seo  ;  Sang Gyune Kim  ;  Chang Hun Lee  ;  Tae Hee Lee  ;  Sang Hoon Ahn  ;  Vincent Wai-Sun Wong  ;  Terry Cheuk-Fung Yip  ;  Lilian Yan Liang  ;  In Hee Kim  ;  Grace Lai-Hung Wong  ;  Seung Up Kim 
 JOURNAL OF DIGESTIVE DISEASES, Vol.24(2) : 113-121, 2023-02 
Journal Title
Issue Date
Antiviral Agents / therapeutic use ; Carcinoma, Hepatocellular* / drug therapy ; Hepatitis B virus ; Hepatitis B, Chronic* / drug therapy ; Humans ; Liver Neoplasms* / drug therapy ; Middle Aged ; Retrospective Studies
CAGE-B ; PAGE-B ; SAGE-B ; hepatitis B ; risk prediction
Objectives: The PAGE-B model consists of variables at the initiation of antiviral therapy (AVT), whereas the SAGE-B and CAGE-B models consist of variables after 5 years of AVT. We aimed to compare the predictive accuracy of three risk prediction models for hepatocellular carcinoma (HCC) development after 5 years of AVT in patients with chronic hepatitis B (CHB).

Methods: A total of 1335 patients who initiated entecavir (ETV) treatment between 2006 and 2011 and were followed up for more than 5 years were enrolled in the study.

Results: At ETV initiation, the median age was 49 years and the median score of the PAGE-B model was 14. After 5 years of ETV treatment, the median SAGE-B and CAGE-B scores were 6 and 6. During the study period, 93 (7.0%) patients developed HCC after 5-year treatment. In multivariate analysis, PAGE-B (hazard ratio [HR] 1.151, 95% confidence interval [CI] 1.087-1.219), SAGE-B (HR 1.340, 95% CI 1.228-1.463), and CAGE-B (HR 1.327, 95% CI 1.223-1.440) models independently predicted HCC development after 5 years of treatment (all P < 0.001). The high-risk groups of the three risk prediction models showed a significantly higher risk of HCC development compared to the medium- and low-risk groups (both P < 0.05). The AUROC of the SAGE-B (0.772-0.844) and CAGE-B (0.785-0.838) models was significantly higher than those of the PAGE-B model (0.696-0.745) in predicting HCC development after 5 years of treatment (both P < 0.05).

Conclusion: The SAGE-B and CAGE-B models might be better than the PAGE-B model in predicting HCC development after 5 years of ETV treatment.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
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