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    Patent Pending

    GALAD Model for Hepatocellular Carcinoma (HCC)

    Diagnoses HCC based on serum biomarkers in patients with chronic liver disease (CLD).
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    When to Use
    Why Use

    Use in patients with chronic liver disease (CLD).

    • Estimates risk that a CLD patient has HCC using only tumor markers and demographics (i.e., no imaging).
    • AUROC was 0.92 in one validation study (Best 2016).
    Female
    Male
    years
    %
    ng/mL
    ng/mL

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Use clinical judgment to determine how closely to surveil patients for HCC.

    Management

    No guidelines currently exist for thresholds at which to image patients based on GALAD results. One large prospective study suggests patients with AFP ≥10 ng/mL or AFP-L3 ≥5% be imaged with CT or MRI every 3-6 months (Kumada 2011).

    Formula

    GALAD Score = -10.08 + 0.09 x A + 1.67 x G + 2.34 log10(AF) + 0.04 x L + 1.33 x log10(D)

    Where variables are as follows:

    Variable

    Value

    Gender

    0 if female

    1 if male

    Age

    Age, years

    AFP-L3

    Alpha fetoprotein L3, %

    AFP

    Alpha fetoprotein, ng/mL

    DCP

    Des-carboxy-prothrombin, ng/mL

    Facts & Figures

    Interpretation:

    Probability of concurrent HCC in this CLD patient = exp(Z) / (1 + exp(Z))

    Where Z = GALAD Score

    Dr. Philip J. Johnson

    About the Creator

    Philip J. Johnson, MD, FRCP, is a professor in translational oncology at the University of Liverpool. He is also the deputy director of the North West Cancer Research Centre, University of Liverpool. Dr. Johnson’s primary research is focused on diagnosis and prognosis of hepatobiliary and pancreatic cancer.

    To view Dr. Philip J. Johnson's publications, visit PubMed