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

Abstract

ObjectivesThe 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).MethodsA 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.ResultsAt 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).ConclusionThe SAGE‐B and CAGE‐B models might be better than the PAGE‐B model in predicting HCC development after 5 years of ETV treatment.