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      Undefined/non-malignant hepatic nodules are associated with early occurrence of HCC in DAA-treated patients with HCV-related cirrhosis

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          Abstract

          An unexpected early increase in incidence, recurrence and clinical aggressiveness of hepatocellular carcinoma (HCC) has been reported (and refuted) in patients with HCV-related cirrhosis following direct-acting antiviral (DAA) treatment. To address this controversy, we performed a prospective multicenter study on consecutively enrolled cirrhotic patients, with or without a history of HCC, undergoing DAA therapy.

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          Most cited references39

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          AASLD guidelines for the treatment of hepatocellular carcinoma.

          Richard Finn, Claude Sirlin, Michael Abecassis … (2018)
          Article 0 comments Cited 1185 times – based on 0 reviews     Review now
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            EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma.

            (2012)
            Article 0 comments Cited 642 times – based on 0 reviews     Review now
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              An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group.

              P Bedossa, T Poynard (1996)
              Histological activity reflects the global assessment of basic necroinflammatory lesions and is a criterion of major importance in chronic hepatitis C. The aim of this study was to propose and test the accuracy of a simple algorithm that generates a single activity score based on basic pathological features. A panel of 10 pathologists reviewed 363 chronic hepatitis C liver biopsies and graded the activity of hepatitis according to their own experience (reference activity). Then, a consensual algorithm on the grading of activity was established by the 10 experts in a panel discussion. Finally, stepwise discriminant analysis was performed to define which basic features had been intuitively used in the reference activity (statistical activity). To test the accuracy of the algorithm, concordance between the activity defined by the algorithm and the reference activity was assessed. It was compared with concordance between the activity defined by the statistical model and the reference activity. The algorithm proposed by the panel for the grading of activity included piecemeal necrosis and lobular necrosis. Concordance between reference activity and activity defined by the algorithm was substantial (305 cases, 84%, kappa = .75). Discriminant analysis showed that piecemeal necrosis, lobular necrosis, and portal inflammation were independently used to grade the activity. Concordance between reference activity and activity defined by the statistical model was substantial (300 cases, 83%, kappa = .73), virtually identical to the concordance between reference activity and activity defined by algorithm. This study proposes a simple algorithm for the grading of activity in chronic hepatitis. Its accuracy is as high as that obtained using a statistical approach.
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                Author and article information

                Journal
                Title: Journal of Hepatology
                Abbreviated Title: Journal of Hepatology
                Publisher: Elsevier BV
                ISSN (Print): 01688278
                Publication date Created: September 2020
                Publication date (Print): September 2020
                Volume: 73
                Issue: 3
                Pages: 593-602
                Article
                DOI: 10.1016/j.jhep.2020.03.030
                PubMed ID: 32243959
                SO-VID: bb8222f6-74d7-44f4-aaf7-072b0d115d8b
                Copyright © © 2020
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                https://www.elsevier.com/tdm/userlicense/1.0/

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