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• W2091465248 abstract "Potential conflict of interest: Nothing to report. Author names in bold denote shared co‐first authorship. To the Editor: We read with interest the article by Suh et al.,1 in which they highlighted that elevated FIB‐4 significantly increased hepatocellular carcinoma (HCC) incidence among hepatitis B surface antigen carriers. Coincidentally, Chon and colleagues showed a middle accuracy of FIB‐4 in predicting HCC development among patients with chronic hepatitis B.2 As we know, FIB‐4 was generally identified as a screening tool for hepatic fibrosis and cirrhosis in chronic hepatitis B patients.3 Given that liver cirrhosis has been defined as an independent predictor of poor survival in hepatitis B–associated HCC,4 it is necessary to investigate whether or not FIB‐4 could also predict survival in these patients. Recently, we conducted a retrospective cohort study and demonstrated that several cirrhosis‐related noninvasive models, including FIB‐4, were valuable for predicting survival in HCC patients without distinguishing hepatitis B from other causes.5 To further evaluate the prognostic significance of FIB‐4 in hepatitis B–associated HCC, herein we involved 324 hepatitis B surface antigen–positive HCC patients. After a median follow‐up period of 44 months, 204 patients died and 148 patients had recurrence. The receiver operating characteristic curve showed an optimal cutoff value of 4.33 for FIB‐4 in predicting postoperative death, with 52.5% sensitivity and 71.7% specificity. A log‐rank test showed that FIB‐4 was significantly associated with overall survival (Fig. 1A) and disease‐free survival (Fig. 1B). The 1‐, 3‐, and 5‐year cumulative overall survival rates were 66.9%, 51.2%, and 42.1%, respectively, for the 183 patients with FIB‐4 <4.33 compared with 50.0%, 28.0%, and 17.2%, respectively, for the 141 patients with a high level. Furthermore, multivariate analysis revealed that FIB‐4 was an independent prognostic factor for overall survival (hazard ratio = 1.47, 95% confidence interval 1.04‐2.08, P = 0.029) and disease‐free survival (hazard ratio = 1.45, 95% confidence interval 1.02‐2.04, P = 0.037) after adjustment for gender, age, Child‐Pugh stage, alpha‐fetoprotein, tumor size, tumor number, and therapeutic method.Figure 1: Kaplan‐Meier survival curves of our study population. Overall survival (A) and disease‐free survival (B) of hepatocellular carcinoma patients stratified according to FIB‐4 levels.In conclusion, FIB‐4 is not only a valuable predictor for cirrhosis and HCC incidence among chronic hepatitis B patients but also significant for predicting postoperative survival in hepatitis B–related HCC." @default.
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• W2091465248 date "2015-03-18" @default.
• W2091465248 modified "2023-10-16" @default.
• W2091465248 title "FIB‐4 as a prognostic model for patients with hepatitis B–associated hepatocellular carcinoma" @default.
• W2091465248 cites W2051118287 @default.
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• W2091465248 doi "https://doi.org/10.1002/hep.27727" @default.
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