GALAD Model for Hepatocellular Carcinoma (HCC)
GALAD Calculator
Gender
years
%
ng/mL
mAU/mL
GALAD Probability:
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Diagnoses HCC based on serum biomarkers in patients with chronic liver disease (CLD).
Why Use
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 ).
When to Use
Use in patients with chronic liver disease (CLD).
Formula
GALAD Score = -10.08 + 0.09 x A + 1.67 x G + 2.34 log 10 (AF) + 0.04 x L + 1.33 x log 10 (D) Where variables are as follows: Variable Value G ender 0 if female 1 if male A ge Age, years AFP- L 3 Alpha fetoprotein L3, % AF P Alpha fetoprotein, ng/mL D CP Des-carboxy-prothrombin, ng/mL
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 ).
Advice
Use clinical judgment to determine how closely to surveil patients for HCC.
More Information
Interpretation: Probability of concurrent HCC in this CLD patient = exp(Z) / (1 + exp(Z)) Where Z = GALAD Score