New Tool Predicts Risk of HCC Among Patients With MASLD
The MASLD-HCC score, developed and validated to estimate hepatocellular carcinoma (HCC) risk in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), demonstrated high predictive performance and consistent calibration across both internal and external cohorts, investigators reported in Clinical Gastroenterology and Hepatology.
A novel cardiometabolic risk factor (CMRF)-based prediction model, the MASLD-HCC score incorporates 5 key variables—overweight/obesity or central obesity, prediabetes or diabetes, age, sex, and platelet count. In the Korean training cohort (n=36,800), the model achieved a Harrell’s C-index of 0.84. Performance remained strong in the internal Korean validation cohort (n=36,799; C-index 0.83) and was even higher in the external multinational cohort (n=4,078; C-index 0.93), which included patients from 11 Asian and Western countries. Calibration was robust across all cohorts, and decision curve analysis confirmed a net clinical benefit for patients.
HCC developed in 71 (0.2%) patients during a median follow-up of 5.1 years in the training cohort. Among the examined CMRFs, both overweight/obesity (or central obesity) and prediabetes/diabetes were independently associated with increased HCC risk. When stratified by MASLD-HCC score, patients in the high-risk group had substantially higher rates of HCC development compared to those in the low-risk group. The subdistribution hazard ratios (sHRs) for high- vs. low-risk groups were significant across all cohorts: training cohort (sHR=11.44; 95% CI, 7.10–18.41), internal validation (sHR=12.36; 95% CI, 7.72–19.79), and external validation (sHR=56.84; 95% CI, 12.88–250.73); all P<.001.
This multinational, multicenter cohort study included 77,677 MASLD patients recruited between 2004 and 2023 from 20 medical centers across Korea and various Asian and Western countries. The model was developed using time-varying Cox multivariable analysis in the training population.
By incorporating simple clinical parameters, the MASLD-HCC score may support individualized surveillance strategies and early intervention in high-risk populations.
Reference:
Chun HS, Lee M, Lee HA, et al. A novel risk prediction model for hepatocellular carcinoma in MASLD: A multinational, multicenter cohort study. Clin Gastroenterol Hepatol. Published online July 9, 2025. doi:10.1016/j.cgh.2025.05.065
