Machine learning for individualized prediction of hepatocellular carcinoma development after the eradication of hepatitis C virus with antivirals.

Hepatitis C Hepatocellular carcinoma Machine learning SVR Surveillance

Journal

Journal of hepatology
ISSN: 1600-0641
Titre abrégé: J Hepatol
Pays: Netherlands
ID NLM: 8503886

Informations de publication

Date de publication:
24 Jun 2023
Historique:
received: 22 06 2022
revised: 03 04 2023
accepted: 23 05 2023
medline: 17 9 2023
pubmed: 17 9 2023
entrez: 16 9 2023
Statut: aheadofprint

Résumé

Accurate risk stratification for hepatocellular carcinoma (HCC) after achieving a sustained viral response (SVR) is necessary for optimal surveillance. We aimed to develop and validate a machine learning (ML) model to predict the risk of HCC after achieving an SVR in individual patients. In this multicenter cohort study, 1742 patients with chronic hepatitis C who achieved an SVR were enrolled. Five ML models were developed including DeepSurv, gradient boosting survival analysis, random survival forest (RSF), survival support vector machine, and a conventional Cox proportional hazard model. Model performance was evaluated using Harrel' c-index and was externally validated in an independent cohort (977 patients). During the mean observation period of 5.4 years, 122 patients developed HCC (83 in the derivation cohort and 39 in the external validation cohort). The RSF model showed the best discrimination ability using seven parameters at the achievement of an SVR with a c-index of 0.839 in the external validation cohort and a high discriminative ability when the patients were categorized into three risk groups (P <0.001). Furthermore, this RSF model enabled the generation of an individualized predictive curve for HCC occurrence for each patient with an app available online. We developed and externally validated an RSF model with good predictive performance for the risk of HCC after an SVR. The application of this novel model is available on the website. This model could provide the data to consider an effective surveillance method. Further studies are needed to make recommendations for surveillance policies tailored to the medical situation in each country. A novel prediction model for HCC occurrence in patients after hepatitis C virus eradication was developed using machine learning algorithms. This model, using seven commonly measured parameters, has been shown to have a good predictive ability for HCC development and could provide a personalized surveillance system.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Accurate risk stratification for hepatocellular carcinoma (HCC) after achieving a sustained viral response (SVR) is necessary for optimal surveillance. We aimed to develop and validate a machine learning (ML) model to predict the risk of HCC after achieving an SVR in individual patients.
METHODS METHODS
In this multicenter cohort study, 1742 patients with chronic hepatitis C who achieved an SVR were enrolled. Five ML models were developed including DeepSurv, gradient boosting survival analysis, random survival forest (RSF), survival support vector machine, and a conventional Cox proportional hazard model. Model performance was evaluated using Harrel' c-index and was externally validated in an independent cohort (977 patients).
RESULTS RESULTS
During the mean observation period of 5.4 years, 122 patients developed HCC (83 in the derivation cohort and 39 in the external validation cohort). The RSF model showed the best discrimination ability using seven parameters at the achievement of an SVR with a c-index of 0.839 in the external validation cohort and a high discriminative ability when the patients were categorized into three risk groups (P <0.001). Furthermore, this RSF model enabled the generation of an individualized predictive curve for HCC occurrence for each patient with an app available online.
CONCLUSIONS CONCLUSIONS
We developed and externally validated an RSF model with good predictive performance for the risk of HCC after an SVR. The application of this novel model is available on the website. This model could provide the data to consider an effective surveillance method. Further studies are needed to make recommendations for surveillance policies tailored to the medical situation in each country.
IMPACT AND IMPLICATIONS UNASSIGNED
A novel prediction model for HCC occurrence in patients after hepatitis C virus eradication was developed using machine learning algorithms. This model, using seven commonly measured parameters, has been shown to have a good predictive ability for HCC development and could provide a personalized surveillance system.

Identifiants

pubmed: 37716372
pii: S0168-8278(23)00424-5
doi: 10.1016/j.jhep.2023.05.042
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Auteurs

Tatsuya Minami (T)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Masaya Sato (M)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Hidenori Toyoda (H)

Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital.

Satoshi Yasuda (S)

Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital.

Tomoharu Yamada (T)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Takuma Nakatsuka (T)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Kenichiro Enooku (K)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Hayato Nakagawa (H)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Hidetaka Fujinaga (H)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Masashi Izumiya (M)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Yasuo Tanaka (Y)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Motoyuki Otsuka (M)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Takamasa Ohki (T)

Department of Gastroenterology, Mitsui Memorial Hospital.

Masahiro Arai (M)

Department of Gastroenterology, Toshiba General Hospital.

Yoshinari Asaoka (Y)

Department of Medicine, Teikyo University School of Medicine.

Atsushi Tanaka (A)

Department of Medicine, Teikyo University School of Medicine.

Kiyomi Yasuda (K)

Department of Gastroenterology, Kiyokawa Hospital.

Hideaki Miura (H)

Department of Gastroenterology, Tokyo Yamate Medical Center.

Itsuro Ogata (I)

Department of Gastroenterology, Kawakita General Hospital.

Toshiro Kamoshida (T)

Department of Gastroenterology, Hitachi General Hospital.

Kazuaki Inoue (K)

Department of Gastroenterology, Showa University Fujigaoka Hospital.

Ryo Nakagomi (R)

Department of Gastroenterology, Kanto Central Hospital of the Mutual Aid Association of Public School Teacher.

Masatoshi Akamatsu (M)

Department of Gastroenterology, JR Tokyo General Hospital.

Hiroshi Mitsui (H)

Department of Gastroenterology, Tokyo Teishin Hospital.

Hajime Fujie (H)

Department of Gastroenterology, Tokyo Shinjuku Medical Center.

Keiji Ogura (K)

Department of Gastroenterology, Tokyo Metropolitan Police Hospital.

Koji Uchino (K)

Department of Gastroenterology, Japanese Red Cross Medical Center.

Hideo Yoshida (H)

Department of Gastroenterology, Japanese Red Cross Medical Center.

Kazuyuki Hanajiri (K)

Department of Gastroenterology, Sanraku Hospital.

Tomonori Wada (T)

Department of Gastroenterology, Sanraku Hospital.

Kiyohiko Kurai (K)

Kurai Kiyohiko Medical Clinic.

Hisato Maekawa (H)

Department of Gastroenterology and Hepatology, Tokyo Takanawa Hospital.

Yuji Kondo (Y)

Department of Gastroenterology and Hepatology, Kyoundo Hospital.

Shuntaro Obi (S)

Department of Gastroenterology and Hepatology, Kyoundo Hospital.

Takuma Teratani (T)

Department of Hepato-Bililary-Pancreatic Medicine, NTT Medical Center Tokyo.

Naohiko Masaki (N)

Clinical Laboratory Department, Center Hospital of the National Center for Global Health and Medicine.

Kayo Nagashima (K)

Department of Gastroenterology, National Disaster Medical Center.

Takashi Ishikawa (T)

Marunouchi Clinic.

Naoya Kato (N)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Hiroshi Yotsuyanagi (H)

Division of Infectious Disease and Applied Immunology, The University of Tokyo the Institute of Medical Science Research Hospital.

Kyoji Moriya (K)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Takashi Kumada (T)

Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital.

Mitsuhiro Fujishiro (M)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Kazuhiko Koike (K)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.

Ryosuke Tateishi (R)

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo. Electronic address: tateishi-tky@umin.ac.jp.

Classifications MeSH