Open AccessValidation of the aMAP score to predict hepatocellular carcinoma development in a cohort of alcohol‐related cirrhosis patients
Author(s) -
Liu Ken,
Yip Terry C. F.,
Masson Steven,
Fateen Waleed,
SchwantesAn TaeHwi,
McCaughan Geoffrey W.,
Morgan Timothy R.,
Aithal Guruprasad P.,
Seth Devanshi
Publication year - 2022
Publication title -
liver cancer international
Language(s) - English
Resource type - Journals
ISSN - 2642-3561
DOI - 10.1002/lci2.47
Subject(s) - hepatocellular carcinoma , medicine , cirrhosis , cohort , hazard ratio , receiver operating characteristic , liver transplantation , cumulative incidence , gastroenterology , transplantation , confidence interval
Background and Aims The aMAP score was recently devised to predict hepatocellular carcinoma (HCC) development. However, its performance was not tested in alcohol‐related cirrhosis (ALC). We aimed to validate the aMAP score in a cohort of ALC patients. Method Study participants with ALC from a prior genome‐wide association study were included. All participants had a history of high alcohol consumption. Cirrhosis was defined clinically, using fibroscan and/or histology. Patients were followed until the last liver imaging, HCC, liver transplantation (LT) or death with the latter two adjusted as competing risks. Results A total of 269 ALC patients were included: male (72.5%), Caucasian (98.9%), median age 56 years, and median Child‐Pugh score 7. The median aMAP score was 60: 12.3% low‐risk, 35.3% medium‐risk and 52.4% high‐risk. After a median follow‐up of 41 months, 14 patients developed HCC, 27 received LT and 104 died. The aMAP score predicted HCC development (hazard ratio 1.12 per point increase, P < .001) with good separation of cumulative incidence function between risk groups. The area under the time‐dependent receiver operating characteristics curve for predicting HCC development was 0.83 at 1 year and 0.82 at 5 years which was similar to ADRESS‐HCC and Veterans Affairs Healthcare System scores respectively. Conclusions We validated the excellent performance of the aMAP score in ALC and affirm its applicability across wider aetiologies.