1. The RETREAT score provides valid predictions regarding hepatocellular carcinoma recurrence after liver transplantation
- Author
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Andreas Schult, Jenny Abrahamsson, Malin Sternby-Eilard, Magnus Rizell, William Bennet, Fredrik Åberg, Clinicum, HUS Abdominal Center, and IV kirurgian klinikka
- Subjects
Male ,medicine.medical_specialty ,recurrence ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,education ,Liver transplantation ,Milan criteria ,03 medical and health sciences ,0302 clinical medicine ,LT ,Risk Factors ,Internal medicine ,medicine ,Humans ,Cumulative incidence ,HCC ,Retrospective Studies ,Transplantation ,business.industry ,Liver Neoplasms ,Mean age ,Patient survival ,Middle Aged ,3126 Surgery, anesthesiology, intensive care, radiology ,medicine.disease ,digestive system diseases ,humanities ,Liver Transplantation ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,030211 gastroenterology & hepatology ,Neoplasm Recurrence, Local ,business ,prognostic - Abstract
Prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) with knowledge of explant data is important for guiding post-LT surveillance and treatment. The RETREAT score was recently introduced for this purpose, but has not been validated outside the USA. In a retrospective single-center study of 169 consecutive patients undergoing LT in Gothenburg, through 2000-2017 (mean age 57 years, 80% men), there were 34 HCC recurrences during a median 4.6-year follow-up. The 5-year cumulative incidence of HCC recurrence was 0% with RETREAT scores of 0-1 (18%), 11-22% with scores of 2-4 (58%), and 65% with scores of 5-8 (24%). The C-statistic, as a measure of discrimination for prediction of HCC recurrence was 0.762, 0.664, 0.616, and 0.717, for the RETREAT score, Milan criteria, UCSF criteria, and post-MORAL criteria. The RETREAT score had no significant impact on patient survival after HCC recurrence (HR 1.00, P = 0.97). In conclusion, the RETREAT score provided valid predictions of post-LT HCC recurrence in a European setting, with the ability to discriminate between high, intermediate, and low risk for HCC recurrence in a clinically important way. Prognosis after recurrence did not differ according to the RETREAT score in our study.
- Published
- 2021