Table 1. Main Variables used for the Markov Model.
Variable | Input data | |
---|---|---|
Basecase scenario | Range | |
Progression of cirrhosis stage per year14 | stage 1 to 2:7% stage 1 to 3: 4% stage 2 to 3: 7% stage 2 to 4: 4% stage 3 to 4: 8% |
stage 1 to 2: 4-10% stage 1 to 3: 2-6% stage 2 to 3: 4-10% stage 2 to 4: 2-6% stage 3 to 4: 6-10% |
Annual hepatic decompensation mortality per cirrhosis stage14 | stage 1: 1% stage 2: 3% stage 3: 20% stage 4: 57% |
stage 1: 0.8-1.3% stage 2: 2.6-4.3% stage 3: 15-25% stage 4: 44-70% |
Annual incidence of HCC9-10 | 3% | 1-5% |
Sensitivity of screening test1 | 70% | 60-80% |
Detection of early stage HCC without surveillance25 | 30% | 25-35% |
Probability of transition from Early to Advanced HCC13 | 63% | 40-86% |
Annual mortality of incurable HCC11,12 | 50% | 45-55% |
Probability of receiving curative treatment for early stage HCC26-27 | 75 % | 70-80% |
Treatment related mortality | ||
LTx15 | 9% in the first 12 months and then 2% annually after the first year | 3-15% in the first 12 months and then 1.5-2.5% annually after the first year |
Surgery19-20 | 5% in the first 6 months and 0% thereafter | 2.5-7.5% in the first 6 months and 0% thereafter |
RFA16-17 | 1% in the first 6 months and 0% thereafter | 0.5-1.5% in the first 6 months and 0% thereafter |
Probability of Liver transplant listing28 | Hepatic decompensation: 17%HCC: 33% | Hepaticdecompensation:11-23%HCC: 29-36% |
Duration of Liver transplant waitlist15 | 12 months | 6-18 months |
Risk of recurrence after treatment within 5 years | ||
LTx22 | 13% over 5 years | 10-16% |
Surgery23 | 70%over 5 years | 65-75% |
RFA21 | 70%over 5 years | 65-75% |
HCC- hepatocellular carcinoma; LTx- liver transplant; MELD- model for end stage liver disease; RFA- radiofrequency ablation