{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:46:33Z","timestamp":1782452793523,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 CA283935"],"award-info":[{"award-number":["U01 CA283935"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P50 CA295495"],"award-info":[{"award-number":["P50 CA295495"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 CA271887"],"award-info":[{"award-number":["U01 CA271887"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Several clinical risk models have been proposed to stratify hepatocellular carcinoma (HCC) risk in patients with chronic hepatitis C virus (HCV) after sustained virologic response (SVR). However, validation efforts have focused on monocentric or country\u2010specific cohorts, and it is unclear if clinical risk models can be broadly applied to global populations. We characterised regional variation in model performance for HCC risk stratification in post\u2010SVR patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four HCC clinical risk models (aMAP score, FIB\u20104 index, GES score, and Toronto HCC risk index [THRI]) were analysed in six real\u2010world cohorts, which included 8796 post\u2010SVR patients from different geographic regions globally. Model discrimination was assessed using Harrel's c\u2010statistic index. HCC incidence rates were compared across low\u2010, intermediate\u2010, and high\u2010risk groups for each model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Distributions of patient characteristics and HCC incidence rates varied across geographic regions. Predictive performances of models were comparable within each cohort despite the model with the highest c\u2010statistics differing by regions. Performance was lower than those from original reports overall; c\u2010statistics of models across most regions remained below 0.70.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There remains a continued need to improve discrimination and calibration of clinical models to stratify HCC risk in post\u2010SVR patients. Accuracy of models may differ by geographic region, underscoring the importance of external validation to assess transportability of models and suggesting no single model can be universally applied.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70734","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T12:43:27Z","timestamp":1780922607000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of Risk Models for Predicting Post\u2010SVR HCC in Real\u2010World Surveillance Across Global Geographic Regions"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-6168","authenticated-orcid":false,"given":"Hidenori","family":"Toyoda","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Ogaki Municipal Hospital  Ogaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujin","family":"Hoshida","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases, Department of Internal Medicine University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-9933","authenticated-orcid":false,"given":"Neehar D.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasun K.","family":"Jalal","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation, Department of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9528-2279","authenticated-orcid":false,"given":"Federico","family":"Pi\u00f1ero","sequence":"additional","affiliation":[{"name":"Hospital Universitario Austral, School of Medicine Austral University  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Mendizabal","sequence":"additional","affiliation":[{"name":"Hospital Universitario Austral, School of Medicine Austral University  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-0683","authenticated-orcid":false,"given":"Ezequiel","family":"Ridruejo","sequence":"additional","affiliation":[{"name":"CEMIC, Centro de Educaci\u00f3n Medica e Investigaciones Clinicas, Norberto Quirno  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Cheinquer","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Division Universidad de Federal Do Rio Grande Do Sul  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Casadei\u2010Gardini","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mounika","family":"Kanneganti","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases, Department of Internal Medicine University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arndt","family":"Weinmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I University Medical Center of the Johannes Gutenberg University  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Peck\u2010Radosavljevic","sequence":"additional","affiliation":[{"name":"Innere Medizin Und Gastroenterologie Klinikum Klagenfurt Am Worthersee  Klagenfurt Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Francois","family":"Dufour","sequence":"additional","affiliation":[{"name":"Hepatology\u2010Department of Biomedical Research University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7208-1477","authenticated-orcid":false,"given":"Pompilia","family":"Radu","sequence":"additional","affiliation":[{"name":"Hepatology\u2010Department of Biomedical Research University of Bern  Bern 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Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4916-9814","authenticated-orcid":false,"given":"Jing\u2010Houng","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Hepatogastroenterology, Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pisit","family":"Tangkijvanich","sequence":"additional","affiliation":[{"name":"Center of Excellence in Hepatitis and Liver Cancer, Faculty of Medicine Chulalongkorn University  Bangkok 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akito","family":"Nozaki","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Nakamuta","sequence":"additional","affiliation":[{"name":"National Hospital Organization Kyushu Medical Center  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Takaguchi","sequence":"additional","affiliation":[{"name":"Department of Hepatology Kagawa Prefectural Central Hospital  Takamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1989-0480","authenticated-orcid":false,"given":"Atsushi","family":"Hiraoka","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Ehime Prefectural Central Hospital  Matsuyama 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and Validation of Risk Prediction Model for Hepatocellular Carcinoma Development After Sustained Virological Response in Patients With Chronic Hepatitis C","volume":"32","author":"Chun H. S.","year":"2020","journal-title":"European Journal of Gastroenterology & Hepatology"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14378"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/jir.2019.0103"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16632"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1833"},{"key":"e_1_2_11_25_1","first-page":"2205","article-title":"Simple Scoring System for Prediction of Hepatocellular Carcinoma Occurrence After Hepatitis C Virus Eradication by Directacting Antiviral Treatment: All Kagawa Liver Disease Group Study","volume":"19","author":"Tani J.","year":"2020","journal-title":"Oncology Letters"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13278"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000001745"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.05.005"},{"key":"e_1_2_11_29_1","first-page":"836","article-title":"A Blood\u2010Based Prognostic Liver Secretome Signature and Long\u2010Term Hepatocellular Carcinoma Risk in Advanced Liver Fibrosis","volume":"2","author":"Fujiwara N.","year":"2021","journal-title":"Medicus"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.10.035"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.70734","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/liv.70734","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.70734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:01:11Z","timestamp":1782450071000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.70734"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/liv.70734"],"URL":"https:\/\/doi.org\/10.1111\/liv.70734","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"assertion":[{"value":"2026-04-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70734"}}