The rate of liver cancer diagnoses in the United States increases with age. As of 2021, those aged 75 to 79 years had the highest rates of liver cancer. Risk factors for liver cancer include smoking, drinking alcohol, being overweight or obese, and having diabetes. Who is most likely to get liver cancer? Liver cancer in the United States is much more common among men than women. In 2021, there were 12.3 new liver cancer diagnoses among men per 100,000 population, compared to just five new diagnoses per 100,000 women. Concerning race and ethnicity, non-Hispanic American Indians and Alaska Natives and Hispanic have the highest rates of new liver cancer diagnoses. The five-year survival rate for liver cancer in the United States is around 22 percent, however, this rate is much higher among non-Hispanic Asian and Pacific Islanders than other races and ethnicities. Non-Hispanic Asian and Pacific Islanders have a 33 percent chance of surviving the next five years after a liver cancer diagnosis. Deaths from liver cancer In 2020, there were an estimated 20,262 deaths in the United States due to liver cancer. However, the death rate for liver cancer has decreased over the past few years. In the period 1999 to 2020, the death rate for liver cancer reached a high of five deaths per 100,000 population in 2015 but dropped to 4.6 deaths per 100,000 population by 2020. It is estimated that in 2024, there will be over 19,000 liver and intrahepatic bile duct cancer deaths among men in the United States and 10,700 such deaths among women.

In 2021, there were over 5.5 thousand registrations of newly diagnosed liver cancer in England. With a total of 617 cases in this year, the age group most affected by liver cancer in terms of number of cases was that of 70 to 74 year old men. It should of course be noted that the number of people in England in each age group varies and is therefore not necessarily a reflection of susceptibility to liver cancer.

This record contains raw data related to article “Incidence and predictors of hepatocellular carcinoma in patients with autoimmune hepatitis"

Abstract

BackgroundNASH-associated liver cancer (NALC) is a significant contributor to global cancer mortality, closely linked to the increasing prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). This study comprehensively examines the global burden of NALC from 1990 to 2021.MethodsThis study used data from the Global Burden of Disease (GBD) 2021 database to analyze NALC death and age-standardized death rates (ASDR) globally and regionally from 1990 to 2021. We applied Joinpoint regression analysis to assess temporal trends, calculating the annual percent change (APC) and average annual percent change (AAPC). Decomposition analysis was performed to break down mortality changes into contributions from population aging, growth, and epidemiological changes. A frontier analysis was used to evaluate the relationship between NALC burden and sociodemographic development using the Socio-Demographic Index (SDI). Prediction analysis of NALC deaths and ASDR from 2021 to 2045 were estimated using the Nordpred model.ResultsFrom 1990 to 2021, the global burden of NALC deaths increased significantly, with the ASDR rising from 0.38 per 100,000 in 1990 to 0.48 per 100,000 in 2021. Age-specific data in 2021 revealed that NALC deaths peaked in the 65–69 age group for men and 70–74 age group for women. Decomposition analysis indicated that population growth was the most significant contributor to the global NALC death toll, followed by population aging and epidemiological changes. Frontier analysis showed that countries like Mongolia and Gambia were farthest from the disease burden frontier, while Morocco and Ukraine were closest. Prediction analysis suggest a significant increase in NALC deaths by 2045 compared to 2021, with a larger rise in deaths among women.ConclusionThrough this study, a data-driven approach is provided to reduce the global disease burden of NALC. Essential data support for public health prevention strategies is offered, helping guide the development of targeted government interventions. Trends across global regions, countries, age groups, and genders have been analyzed, providing valuable insights for the formulation of evidence-based policies aimed at mitigating the impact of NALC worldwide.

Nonalcoholic steatohepatitis (NASH) is related to metabolic dysregulation and the perturbation of endoplasmic reticulum (ER) homeostasis that frequently develops into hepatocellular carcinoma (HCC). Gp78 is E3 ligase, which regulates endoplasmic reticulum-associated degradation (ERAD) by ubiquitinylation of misfolded ER proteins. Here, we report that upon ageing (12 months), gp78-/- mice developed obesity, recapitulating age-related human NASH. Liver histology of gp78-/- mice revealed typical steatosis, hepatic inflammation and fibrosis, followed by progression to hepatocellular tumors. Acute ER stress revealed that loss of gp78 results in up regulation of unfolded protein response (UPR) pathways and SREBP-1 regulating de novo lipogenesis, responsible for fatty liver. Tissue array of human hepatocellular carcinoma (HCC) demonstrated that the expression of gp78 was inversely correlated with clinical grades of cancer. Here, we have described the generation of the first preclinical experimental model system which spontaneously develops age-related NASH and HCC, linking ERAD to hepatosteatosis, cirrhosis, and cancer. It suggests that gp78 is a regulator of normal liver homeostasis and a tumor suppressor in human liver.

Cancer was responsible for around 142 deaths per 100,000 population in the United States in 2022. The death rate for cancer has steadily decreased since the 1990’s, but cancer still remains the second leading cause of death in the United States. The deadliest type of cancer for both men and women is cancer of the lung and bronchus which will account for an estimated 65,790 deaths among men alone in 2024. Probability of surviving Survival rates for cancer vary significantly depending on the type of cancer. The cancers with the highest rates of survival include cancers of the thyroid, prostate, and testis, with five-year survival rates as high as 99 percent for thyroid cancer. The cancers with the lowest five-year survival rates include cancers of the pancreas, liver, and esophagus. Risk factors It is difficult to determine why one person develops cancer while another does not, but certain risk factors have been shown to increase a person’s chance of developing cancer. For example, cigarette smoking has been proven to increase the risk of developing various cancers. In fact, around 81 percent of cancers of the lung, bronchus and trachea among adults aged 30 years and older can be attributed to cigarette smoking. A recent poll indicated that many U.S. adults believed smoking cigarettes and using other tobacco products increased a person’s risk of developing cancer, but a much smaller percentage believed the same for proven risk factors such as obesity and drinking alcohol.

Cumulative hepatocellular carcinoma incidence (%) in subgroups by age, sex, cirrhosis, diabetes mellitus, or other non-hepatic events.

Legacy unique identifier: P00325

Legacy unique identifier: P00326

In 2023, California had the highest number of liver transplants performed among all U.S. states. That year, there were around 1,200 liver transplants performed in California. The state with the second highest number of liver transplants was Texas. Liver transplants are the second most common transplant in the United States, behind kidney transplants. Liver transplants in the United States In 2022, there were just over 9,500 liver transplants carried out in the United States. Most liver transplants in the U.S. are among adults aged 50 to 64 years, with this age group accounting for around 45 percent of all liver transplants in 2023. The current need for liver transplants exceeds availability, with over 10 thousand people in the United States waiting to receive a liver transplant. Liver transplantation is a treatment option for those suffering from end-stage chronic liver disease, in which the liver is damaged beyond repair. Liver disease End-stage chronic liver disease, or liver failure, has various causes including cirrhosis, hepatitis B and C, and liver cancer. Around half of all deaths in the United States caused by liver cirrhosis are related to alcohol use. Liver cirrhosis is scarring of the liver because of long-term damage. The death rate due to alcohol-related cirrhosis in the United States has increased over the past couple decades. Men are much more likely to die from liver cirrhosis than women.

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Demographic Summary of Available Imaging

Characteristic	Value (N = 190)
Age (months)	Mean ± SD: 25.3 ± 29 Median (IQR): 17 (10-30.2) Range: 0-189
Sex	Male: 120 (63%) Female: 70 (37%)
Race	Not Available
Ethnicity	Not Available

This collection contains data from the National Cancer Institute Clinical Trial NCT00980460, "Risk-Based Therapy in Treating Younger Patients With Newly Diagnosed Liver Cancer." It was sponsored by NCI's Children’s Oncology Group (COG) under study number AHEP0731. This phase III trial studies the side effects and how well risk-based therapy works in treating younger patients with newly diagnosed liver cancer. Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.

Trial Description

Surgery, chemotherapy drugs (cancer fighting medicines), and when necessary, liver transplant, are the main current treatments for hepatoblastoma. The stage of the cancer is one factor used to decide the best treatment. Treating patients according to the risk group they are in may help get rid of the cancer, keep it from coming back, and decrease the side effects of chemotherapy.

Hepatoblastoma treatment with curative intent requires surgical resection, but only about a third of newly diagnosed patients with hepatoblastoma have resectable disease at diagnosis. Patients who have upfront resection typically receive a total of 4–6 cycles of adjuvant chemotherapy post-surgery, with the combination of cisplatin, fluorouracil, and vincristine. The aim is to investigate whether event-free survival in children with hepatoblastoma who had complete resection at diagnosis could be maintained with two cycles of adjuvant chemotherapy. This multicentre, phase 3 trial was designed to test a risk-based treatment approach for children with hepatoblastoma, to diminish toxicity in low-risk patients, improve survival in intermediate-risk patients, and identify new agents that may be used in high-risk and recurrent patients. Patients were staged for risk classification using the Children’s Oncology Group staging guidelines before the initiation of chemotherapy, with stage IV indicating metastatic disease. Pretreatment extent of disease (PRETEXT) grouping also was performed at the time of diagnosis and with any subsequent abdominal computed tomography or magnetic resonance imaging and was used to guide the surgical management but was not used for risk classification. The response rate and outcome to the combination of vincristine and irinotecan administered in an upfront window to children newly diagnosed with high-risk hepatoblastoma was determined.

For Low-Risk patients CT chest was used for metastatic tumor response assessment. Abdominal Ultrasound was obtained at baseline. For Intermediate- and High-Risk patients abdominal ultrasound, CT and/or MRI was used for primary tumor response assessment and CT chest for metastatic tumor response assessment.

Trial Outcomes

Results of the trial for Low-Risk patients have been reported in the following publication:

Katzenstein, H. M., Langham, M. R., Malogolowkin, M. H., Krailo, M. D., Towbin, A. J., McCarville, M. B., Finegold, M. J., Ranganathan, S., Dunn, S., McGahren, E. D., Tiao, G. M., O’Neill, A. F., Qayed, M., Furman, W. L., Xia, C., Rodriguez-Galindo, C., & Meyers, R. L. (2019). Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children’s Oncology Group, multicentre, phase 3 trial. The Lancet Oncology, 20(5), 719–727. DOI: https://doi.org/10.1016/s1470-2045(18)30895-7. Epub 2019 Apr 8. Erratum in: Lancet Oncol. 2019 May;20(5):e243. PMID: 30975630; PMCID: PMC6499702. Epub 2019 Apr 8. Erratum in: Lancet Oncol. 2019 May;20(5):e243. PMID: 30975630; PMCID: PMC6499702.

Background: Liver resection (LR) remains the best therapeutic option for patients with early-stage hepatocellular carcinoma (HCC) with preserved hepatic function and who are not eligible for liver transplantation. After its inception, the enhanced recovery after surgery (ERAS) protocol was widely used for treating patients with liver cancer, although there are still no clear indications for improving upon it in both open and laparoscopic surgery.

Objective: This study aims to describe our institute's experience in the application of the ERAS protocol in a cohort of HCC patients, and to explore possible factors that could have an impact on postoperative outcomes.

Materials and Methods: We retrospectively analyzed our experience with LR performed from September 2017 to January 2020 in patients treated with ERAS protocol, focusing on describing impact on postoperative nutrition, analgesic requirements, and length of hospitalization. Demographics, operative factors, and postoperative complications of patients were reviewed.

Results: During the study period, 89 HCC patients were eligible for LR, and 75% of patients presented with liver cirrhosis. The most prevalent among etiologic factors was hepatitis C virus infection (53 patients out of 89, 60%), followed by nonalcoholic steatohepatitis (18 patients, 20%). The median age was 70 years. Liver cirrhosis did not have an impact on postoperative course of patients. Patients who underwent laparoscopic surgery and nonanatomic LR experienced low complication rates, shorter length of stay, and shorter time of intravenous analgesic requirements.

Conclusions: Continual refinement with ERAS protocol for treating HCC patients based on perioperative counseling and surgical decision-making is crucial to guarantee low complication rates, and reduce patient morbidity and time for recovery.

Market Overview:

The 7 major hepatocellular carcinoma markets reached a value of US$ 780 Million in 2023. Looking forward, IMARC Group expects the 7MM to reach US$ 1,520 Million by 2034, exhibiting a growth rate (CAGR) of 6.3% during 2024-2034.

The hepatocellular carcinoma market has been comprehensively analyzed in IMARC's new report titled "Hepatocellular Carcinoma Market: Epidemiology, Industry Trends, Share, Size, Growth, Opportunity, and Forecast 2024-2034". Hepatocellular carcinoma (HCC) is a type of oncological disease that arises from the hepatocytes or liver cells. It is a severe illness that can destroy hepatic cells and interfere with the liver's ability to function, causing life-threatening complications. The symptoms of the ailment vary depending on the stage and size of the tumor, and many people may not experience any indications at all. Some of the non-specific symptoms include abdominal pain, nausea, vomiting, tiredness, etc. Individuals suffering from hepatocellular carcinoma may also experience yellow skin, loss of appetite, abdominal swelling, unintentional weight loss, easy bruising, etc. The diagnosis of this ailment is typically based on the patient's symptoms, blood testing, and imaging evaluation. The healthcare provider may also perform numerous diagnostic procedures, such as multi-phase computerized tomography scans and contrast-enhanced magnetic resonance imaging, to detect disease staging among patients. Additionally, a biopsy or ultrasound of the tumor is required to confirm the diagnosis of hepatocellular carcinoma.

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The increasing incidences of chronic hepatitis B and C infections, which cause long-term liver inflammation and lead to the development of cirrhosis, are primarily driving the hepatocellular carcinoma market. In addition to this, the rising prevalence of several associated risk factors, including excessive alcohol consumption, obesity, diabetes, accumulation of fat in the liver, etc., is also bolstering the market growth. Furthermore, the widespread adoption of monoclonal antibodies for treating unresectable or advanced disease conditions is acting as another significant growth-inducing factor. This medication can prevent the proliferation of unhealthy cells, thereby reducing tumors' ability to grow and metastasize. Additionally, the escalating demand for locoregional therapies, such as thermal ablation and transarterial chemoembolization, that aim to decrease tumor viability, delay disease progression, and ultimately extend overall survival is also creating a positive outlook for the market. Moreover, the inflating utilization of selective internal radiation therapy, which potently delivers millions of tiny radioactive beads directly to liver tumors and provides cancer irradiation, is further augmenting the market growth. Apart from this, the emerging popularity of percutaneous ethanol injection among patients with early-stage HCC who are not candidates for surgery or other more invasive treatments is expected to drive the hepatocellular carcinoma market in the coming years.

IMARC Group's new report provides an exhaustive analysis of the hepatocellular carcinoma market in the United States, EU4 (Germany, Spain, Italy, and France), United Kingdom, and Japan. This includes treatment practices, in-market, and pipeline drugs, share of individual therapies, market performance across the seven major markets, market performance of key companies and their drugs, etc. The report also provides the current and future patient pool across the seven major markets. According to the report, the United States has the largest patient pool for hepatocellular carcinoma and also represents the largest market for its treatment. Furthermore, the current treatment practice/algorithm, market drivers, challenges, opportunities, reimbursement scenario, unmet medical needs, etc., have also been provided in the report. This report is a must-read for manufacturers, investors, business strategists, researchers, consultants, and all those who have any kind of stake or are planning to foray into the hepatocellular carcinoma market in any manner.

Recent Developments:

• In April 2024, Geneos Therapeutics released positive findings from its Phase I/II GT-30 clinical trial of GNOS-PV02, a personalized neoantigen vaccine, in combination with pembrolizumab for advanced hepatocellular carcinoma. The data demonstrated that nearly a third of the patients treated with this combination therapy observed tumor shrinkage, with three of those individuals attaining a complete response, which means no visible tumor signs remained after a median follow-up of 21.5 months.
• In November 2023, SCG Cell Therapy Pte Ltd (SCG) presented late-breaking clinical data from its first-in-class autologous hepatitis B virus (HBV)-specific T-cell receptor-engineered T Cell (TCR-T) treatment, SCG101, at the 2023 AASLD Liver Meeting in Boston, United States. In a first-in-human clinical trial, SCG101 displayed potential antiviral and anticancer activity in patients with advanced HBV-related hepatocellular carcinoma.
• In June 2023, Tvardi Therapeutics, Inc. disclosed that the first patients had been dosed in every arm of its ongoing REVERT LIVER CANCER study. The trial evaluates the safety and therapeutic activity of TTI-101 as monotherapy and in conjunction with standard-of-care therapy in patients with locally advanced or metastatic and unresectable hepatocellular carcinoma.
• In February 2023, Genoscience Pharma reported that its leading candidate, ezurpimtrostat, a PPT-1 (Palmitoyl Protein Thioesterase-1) inhibitor, has received Orphan Drug Designation (ODD) from the US FDA for the treatment of hepatocellular carcinoma.

Key Highlights:

• Hepatocellular carcinoma is diagnosed in around 900,000 people globally each year.
• It is the fifth most prevalent malignancy in men (69.8% of all hepatocellular carcinoma cases) and the ninth among women.
• According to the Global Cancer Observatory (GCO), Asia accounts for 72.5% of all HCC cases, with 11.6 new cases per 100,000 population.
• HCC is less prevalent in the US and Europe, with 5.2 new cases per 100,000 people per year.
• About 830,000 individuals die from HCC annually, making it the third most common cause of cancer-related deaths worldwide.
• The Surveillance, Epidemiology, and End Results (SEER) Program indicated a 20.3% 5-year relative survival rate for individuals diagnosed with HCC.

Drugs:

KEYTRUDA is an anti-programmed death receptor-1 (PD-1) medication that enhances the immune system's ability to detect and attack tumor cells. KEYTRUDA is a humanized monoclonal antibody that inhibits the interaction of PD-1 and its ligands, PD-L1 and PD-L2, activating T lymphocytes that can affect both tumor and healthy cells.

GC33 is a humanized monoclonal antibody created by Chugai. The drug targets glypican-3 (GPC3), which is specifically expressed in hepatocellular carcinoma.

TTI-101 is under clinical development by Tvardi Therapeutics for metastatic hepatocellular carcinoma. It is an oral small molecule STAT3 inhibitor. STAT3 is a regulatory molecule that contributes considerably to hepatocellular carcinoma progression.

Time Period of the Study

• Base Year: 2023
• Historical Period: 2018-2023
• Market Forecast: 2024-2034

Countries Covered

• United States
• Germany
• France
• United Kingdom
• Italy
• Spain
• Japan
  

Analysis Covered Across Each Country

• Historical, current, and future epidemiology scenario
• Historical, current, and future performance of the hepatocellular carcinoma

Legacy unique identifier: P00237

Introduction: Hepatocellular carcinoma (HCC) accounts for nearly 90% of primary liver cancers, with estimates of over 1 million people affected by 2025. We aimed to explore the impacting role of an iterative surgical treatment approach in a cohort of HCC patients within the Milan criteria, associated with clinical risk factors for tumor recurrence (RHCC) after liver transplant (LT) and loco-regional therapies (LRT), as well as liver resection (LR) and/or microwave thermal ablation (MWTA).

Methods: We retrospectively analyzed our experience performed during an 8-year period between January 2013 and December 2021 in patients treated for HCC, focusing on describing the impact on preoperative end-stage liver disease severity, oncologic staging, tumor characteristics, and surgical treatments. The Cox model was used to evaluate variables that could predict relapse risks. Relapse risk curves were calculated according to the Kaplan-Meier method, and the log-rank test was used to compare them.

Results: There were 557 HCC patients treated with a first-line approach of LR and/or LRTs (n = 335) or LT (n = 222). The median age at initial transplantation was 59 versus 68 for those whose first surgical approach was LR and/or LRT. In univariate analysis with the Cox model, nodule size was the single predictor of recurrence of HCC in the posttreatment setting (HR: 1.61, 95% CI: 1.05-2.47, p = 0.030). For the LRT group, we have enlightened the following clinical characteristics as significantly associated with RHCC: hepatitis B virus infection (which has a protective role with HR: 0.34, 95% CI: 0.13-0.94, p = 0.038), number of HCC nodules (HR: 1.54, 95% CI: 1.22-1.94, p < 0.001), size of the largest nodule (HR: 1.06, 95% CI: 1.01-1.12, p = 0.023), serum bilirubin (HR: 1.57, 95% CI: 1.03-2.40, p = 0.038), and international normalized ratio (HR: 16.40, 95% CI: 2.30-118.0, p = 0.006). Among the overall 111 patients with RHCC in the LRT group, 33 were iteratively treated with further curative treatment (12 were treated with LR, two with MWTA, three with a combined LR-MWTA treatment, and 16 underwent LT). Only one of 18 recurrent patients previously treated with LT underwent LR. For these RHCC patients, multivariable analysis showed the protective roles of LT for primary RHCC after IDLS (HR: 0.06, 95% CI: 0.01-0.36, p = 0.002), of the time relapsed between the first and second IDLS treatments (HR: 0.97, 95% CI: 0.94-0.99, p = 0.044), and the impact of previous minimally invasive treatment (HR: 0.28, 95% CI: 0.08-1.00, p = 0.051).

Conclusion: The coexistence of RHCC with underlying cirrhosis increases the complexity of assessing the net health benefit of ILDS before LT. Minimally invasive surgical therapies and time to HCC relapse should be considered an outcome in randomized clinical trials because they have a relevant impact on tumor-free survival.

The annexes A to E to the Scientific Opinion on Aflatoxins in Food included in the upload are excel files as follows:

• Annex A: Dietary surveys per country and age group available in the EFSA Comprehensive Database, considered in the exposure assessment
• Annex B: Occurrence data on aflatoxins
• Annex C: Proportion of left-censored data and the mean concentrations of the quantified analytical results of AFB1 for pistachios, hazelnuts, peanuts, other nuts and dried figs
• Annex D: AFB1 and AFM1 concentrations reported for organic farming and conventional farming in selected food categories
• Annex E: Mean and high chronic dietary exposure to aflatoxins per survey and the contribution of different food groups to the dietary exposure

This record contains raw data related to article “Charlson comorbidity index and G8 in older old adult(≥80 years) hepatocellular carcinoma patients treated with stereotactic body radiotherapy"

Introduction: Hepatocellular Carcinoma (HCC) is characterized, in Western countries, by higher incidence and mortality rates in the older adult population. In frail patients, limited therapeutic resources are available due to limited expected benefit concerning the risk of treatment-related toxicity. The aim of our study is to evaluate the role of Stereotactic Body Radiotherapy (SBRT) in the clinical management of older old adults (age ≥ 80 years) HCC patients and to identify predictors of efficacy and toxicity.

Material and methods: Clinical and treatment-related data of older old adults HCC patients treated with SBRT at our institution were retrospectively reviewed. Statistical analysis was carried out to identify variables correlated with impaired outcome and toxicity.

Results: Forty-two patients were included, accounting for 63 treated tumors. Median age was 85 (range 80-91) years. Median Charlson Comorbidity Index (CCI) and G8 scores were 10 (range 7-16) and 11 (range 8-14), respectively. SBRT was administered to a median BED10 of 103 Gy10. Median follow-up interval was 11 (range 3-40) months. Two years Local Control (LC), Progression-Free Survival (PFS), and Overall Survival (OS) were 93%, 31%, and 43%, respectively. Acute toxicity occurred in 28% (n = 13) of treatments. A G8 score > 10 was associated with improved survival (p = 0.045), while a CCI ≥10 was correlated with increased acute toxicity (p = 0.021).

Conclusions: SBRT is a safe and effective option in older old adults HCC patients. A comprehensive geriatric assessment (CGA) is advised before treatment decisions to select optimal candidates for SBRT.

UNLABELLED: The age and risk level that warrants hepatocellular carcinoma (HCC) screening remains to be defined. To develop risk scores for stratifying average-risk population for mass HCC screening, we conducted a pooled analysis using data from three cohorts involving 12,377 Taiwanese adults 20-80 years of age. During 191,240.3 person-years of follow-up, 387 HCCs occurred. We derived risk scores from Cox's model in two thirds of participants and used another one third for model validation. Besides assessing discrimination and calibration, we performed decision curve analysis to translate findings into public health policy. A risk score according to age, sex, alanine aminotransferase, previous chronic liver disease, family history of HCC, and cumulative smoking had good discriminatory accuracy in both model derivation and validation sets (c-statistics for 3-, 5-, and 10-year risk prediction: 0.76-0.83). It also performed well across cohorts and diverse subgroups. Decision curve analyses revealed that use of the score in selecting persons for screening improved benefit at threshold probabilities of >2% 10-year risk, compared with current guidelines and a strategy of screening all hepatitis B carriers. Using 10-year risk 2% as a threshold for initiating screening, the screening age ranged from 20 to >/=60 years, depending on the tertile of risk scores and status of hepatitis B/C virus infection. Combining risk-score tertile levels and hepatitis virus status to stratify participants was more sensitive than current guidelines for HCC detection within 10 years (89.4% vs. 76.8%), especially for young-onset HCCs ＜50 years (79.4% vs. 40.6%), under slightly lower specificity (67.8% vs. 71.8%). CONCLUSION: A simple HCC prediction algorithm was developed using accessible variables combined with hepatitis virus status, which allows selection of asymptomatic persons for priority of HCC screening.

We report that 7 of 7 female Gnmt-/- mice developed hepatocellular carcinoma (HCC), the most common form of liver cancer, at the mean age of 16.1 months. In contrast, only one-third (2/6) of male Gnmt-/- mice had HCC, the remaining had either premature death or liver necrosis. Microarray analysis showed that genes involved in the following pathways were deregulated in different stages of tumorigenesis: S-adenosylmethionine (SAM)-dependent methyltransferases, metabolism, signal transduction, cell proliferation, cell adhesion and immune responses. This study reveals that GNMT plays an important role in the prevention of hapatotumorigenesis through regulating DNA methylaiton and oxidative stress signaling pathways. We postulate that GNMT is a stress-responsive protein and its expression may account for the gender difference of the susceptibility to liver cancer. Keywords: Gnmt knockout Liver tissues from wild-type or Gnmt knockout mice at young ages, devoloping dysplasia nodules or HCC were used for RNA extraction and hybridization on Affymetrix microarrays. For 11 weeks old mice, total RNA were mixed in equal proportion from 3 mice.

Hepatocellular carcinoma incidence rates in patients with steatotic liver disease, overall and in subgroups by age, sex, cirrhosis, diabetes mellitus, or other non-hepatic events.