{
  "abstract": "Introduction Surveillance for hepatocellular carcinoma (HCC) with 6 monthly ultrasound and AFP is recommended for people with cirrhosis or other high-risk conditions, aiming to detect HCC at a potentially curable stage. However, this is resource intensive and many won’t benefit due to low risk and some may be harmed through ‘false alarms’. aMAP (age, sex, albumin, bilirubin, platelets) is an objective tool to predict risk of HCC development. Prospective studies showed that individuals with aMAP <50 have a low risk of HCC over 5 years and may therefore not need surveillance. Our aim was to review what proportion of patients diagnosed with HCC in our region would be missed if aMAP was used to select patients for surveillance.Methods All patients with a new HCC diagnosis from our regional MDM were included from Sept 24-25. Records were retrospectively reviewed to calculate aMAP scores 12 months prior to HCC diagnosis. aMAP scores range 0-100 (<50 low risk, 50-59 medium risk, ≥60 high risk). Relationships between aMAP and HCC were explored.Results aMAP scores were available for 134 patients (median age 70, range 30-88 years; 81% male; 75% were cirrhotic [histologic or radiographic diagnosis]). BCLC stage at diagnosis was 13% A, 17% B, 54% C and 16% D. The mean time between aMAP and HCC diagnosis was 12.4 (range 6-18) months. Overall, 91% of patients had an aMAP >50. Median aMAP scores for fibrosis stages are shown in table 1. 100 patients had cirrhosis, predominantly ArLD, MASLD and MetALD. aMAP scores did not differ significantly between aetiology (Kruskal-Wallis test p=0.071). Only 6% of cirrhotic patients had low aMAP scores, representing 94% sensitivity of aMAP in distinguishing higher-risk cirrhotic groups. 24% of the non-cirrhotic cohort (surveillance not recommended) had a low aMAP score. There was no statistically significant difference between aMAP score compared across BCLC stage (p=0.376). The 6 patients with cirrhosis and low aMAP scores had a median largest tumour size of 5.35cm (range 1.4-10.6cm). There was no significant correlation between aMAP score and largest tumour size (p=0.215).Conclusion Overall, aMAP >50 has a high sensitivity for HCC in patients with cirrhosis and may therefore be used to select patients for surveillance. This approach could help focus surveillance resources on those most likely to benefit.Abstract P93 Table 1aMAP by fibrosis stageCirrhosisF2-F3F0-F1IndeterminateTotal (n)10061513Low aMAP (n)6141Medium aMAP (n)24567High aMAP (n)70055aMAP*64.3 (IQR 58.7-68.9)53.7 (IQR 51.2-55.4)54.5 (IQR 50.9-61.8)58.6 (IQR 54.6-62.7)Age* (y)69 (IQR 64-75)67 (IQR 60-68)72 (IQR 64-75)73 (IQR 67-79)Albumin* (g/L)40 (IQR 38–42)44 (IQR 43-45)42 (IQR 41-44)42 (IQR 39-44)Bilirubin* (µmol/L)14 (IQR 10-22)6 (IQR 3-10)8 (IQR 7-16)7 (IQR 6-10)Platelets* (x109/L)158 (IQR 101-206)243 (IQR 213-273)247 (IQR 218-273)249 (IQR 189-301)*Median",
  "authors": [
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust"
      ],
      "name": "Laura Checkett"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust"
      ],
      "name": "Louise MacDougall"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust",
        "Translational and Clinical Research Institute, Newcastle University and Newcastle NIHR Biomedical Research Centre"
      ],
      "name": "Daniel Geh"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust",
        "Translational and Clinical Research Institute, Newcastle University and Newcastle NIHR Biomedical Research Centre"
      ],
      "name": "Helen Reeves"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust"
      ],
      "name": "Nicola Holmes-Long"
    },
    {
      "affiliations": [
        "Liver Unit, The Newcastle upon Tyne NHS Foundation Trust",
        "Translational and Clinical Research Institute, Newcastle University and Newcastle NIHR Biomedical Research Centre"
      ],
      "name": "Stuart McPherson"
    }
  ],
  "title": "P93 aMAP score has high sensitivity for HCC in people with cirrhosis: a potential tool to select patients for surveillance",
  "uid": "d6ba8264-1eca-50ed-a3ae-e95859ba83d4"
}