Models to Predict Development or Recurence of Hepatocellular Carcinoma (HCC) in Patients with Advanced Hepatic Fibrosis

Abstract

Purpose of Review Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death in the United States (U.S.).1 The purpose of this review is to highlight published models that predict development of HCC and estimate risk of HCC recurrence after treatments. Recent Findings There have been several models created for both de novo HCC and HCC recurrence, with the more recent models using a combination of age, sex, decompensation, and laboratory values (platelet count, albumin, bilirubin), and liver disease etiology to predict both 5 and 10-year HCC incidence. For chronic hepatitis C, sustained virologic response has been a useful component of understanding HCC risk reduction. BMI and diabetes have been utilized in non-alcoholic fatty liver disease (NAFLD) models to predict HCC risk. For HCC recurrence after treatment (for both surgical resection and liver transplant), tumor size and number, vascular invasion, alpha-fetoprotein (AFP) and neutrophil to lymphocyte ratio (NLR) are all components of HCC recurrence risk models. Summary Although numerous HCC risk prediction models have been established over the last several years, challenges remain including how to best incorporate these models into clinical practice, improve surveillance for NAFLD-HCC development, and determine timing and duration of post-resection recurrence surveillance.

Monocytes Subsets Altered Distribution and Dysregulated Plasma hsa-miR-21-5p and hsa- miR-155-5p in HCV-Linked Liver Cirrhosis Progression to Hepatocellular Carcinoma

“…In contrast, Du et al [44] found that elevated NLR is associated with HCC development in cirrhotic patients with HBV who underwent splenectomy for hypersplenism. Yilma et al [45] suggested that NLR was a component of HCC development and recurrence risk models in the context of CHCV. Currently, PLR showed no signi cant differences among the three groups, which disagrees with Catanzaro et al [46] who inferred PLR to be used as a predictive marker for LC.…”

Correlation between preoperative systemic immune inflammation index, nutritional risk index, and prognosis of radical resection of liver cancer

“…Height and weight are often used to evaluate the nutritional status of individuals. Yilma et al [ 25 ] reported that a low body mass index is associated with HCC development and recurrence. Fischer et al [ 26 ] proposed that overweight and obesity are more conducive to short-term prognosis after major hepatectomy than a normal body mass index.…”

Hypoalbuminemia Is a Hepatocellular Carcinoma Independent Risk Factor for Tumor Progression in Low-Risk Bridge to Transplant Candidates

“…In a 5-year cohort of transplant candidates monitored from first cycle LDT, multivariate analysis of TTP revealed albumin level prior to first cycle was the only HCC-independent variable associated with TTP risk. Albumin is a well-known risk factors for developing HCC [ 14 ] and, when incorporated into the ALBI grade and several other prognostic scores, can stratify PFS and OS outcomes following LDT as well as OS and RFS after hepatectomy or LT (recently reviewed in [ 15 , 16 , 17 , 18 ]). There have been far fewer studies investigating a direct relationship between albumin and HCC progression independent of overall mortality.…”