NDLI: Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database

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Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database

Content Provider	Scilit
Author	Mehta, Neil Dodge, Jennifer L. Roberts, John P. Yao, Francis Y.
Copyright Year	2017
Description	Journal: American Journal of Transplantation Researchers in a recent multicenter study developed and validated a novel prognostic index, Risk Estimation of Tumor Recurrence After Transplant (RETREAT), which incorporates α‐fetoprotein (AFP) at liver transplantation (LT), microvascular invasion, and the sum of the largest viable tumor and number of tumors on explant. We now aim to evaluate RETREAT in the United Network for Organ Sharing (UNOS) database in patients with hepatocellular carcinoma (HCC) who meet Milan criteria by imaging and underwent LT between 2012 and ‐2014. On explantation (n = 3276), 13% had microvascular invasion, 30% had no viable tumor, and 15% exceeded Milan criteria. Post‐LT survival at 3 years decreased with increasing RETREAT score: 91% for a score of 0, 80% for a score of 3, and 58% for a score ≥5 (P < .001). Post‐LT HCC recurrence probability within 3 years increased from 1.6% with RETREAT score of 0% to 29% for a score ≥5 (P < .001). Increasing RETREAT score was also associated with a shorter time to HCC recurrence. RETREAT was superior to Milan criteria (explant) in predicting HCC recurrence by the net reclassification index (P < .001). This study validates the prognostic power of RETREAT, which may help standardize post‐LT surveillance, provide a framework for tumor staging and risk stratification, and select candidates for adjuvant therapies.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445634/pdf
Ending Page	1213
Page Count	8
Starting Page	1206
e-ISSN	16006143
DOI	10.1111/ajt.14549
Journal	American Journal of Transplantation
Issue Number	5
Volume Number	18
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2017-10-25
Access Restriction	Open
Subject Keyword	Journal: American Journal of Transplantation Classification Systems: Milan Criteria Clinical Research/practice Health Services and Outcomes Research Liver Disease: Malignant Liver Transplantation/hepatology Organ Procurement and Allocation Organ Procurement and Transplantation Network (optn) Recurrent Disease United Network for Organ Sharing (unos)
Content Type	Text
Resource Type	Article

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