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

Abstract

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 compared 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). A total of 1,335 patients who initiated entecavir (ETV) treatment between 2006 and 2011 and were followed up for more than 5 years were enrolled in the stduy. At ETV initiation, the median age of the patients was 49 years and the median of the PAGE-B model was 14. After 5 years of ETV treatment, the median SAGE-B and CAGE-B values were 6 and 6, respectively. 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 (all P<0.05). The areas under the receiver operating characteristic curves of the SAGE-B (0.772-0.844) and CAGE-B (0.785-0.838) models were significantly higher than those of the PAGE-B model (0.696-0.745) in predicting HCC development after 5 years of treatment (all P<0.05). 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 in patients with CHB.