ArticleAnnals of surgery2017
Prediction of Hepatocellular Carcinoma Recurrence Beyond Milan Criteria After Resection: Validation of a Clinical Risk Score in an International Cohort.
Article in Annals of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
69 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- Meta-analysis of Prognostic Factors for Overall Survival Among Resected Patients with Spontaneous Ruptured Hepatocellular Carcinoma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma.Clinical and molecular hepatology · 2022Guideline
- 2018 Korean Liver Cancer Association-National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma.Korean journal of radiology · 2019Guideline
- 2018 Korean Liver Cancer Association-National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma.Gut and liver · 2019Guideline
- Targeted Therapy and Immunotherapies in Hepatocellular Carcinoma: Mechanisms and Clinical Studies.MedComm · 2026Review
- Article
- Reply to Letter to the Editor: Predicting Late Tumor Recurrence in Surgical Hepatocellular Carcinoma: What have We Missed?Annals of surgical oncology · 2026Article
- Analysis of survival prognosis and influencing factors in patients with primary liver cancer after D-TACE: a retrospective cohort study.BMC gastroenterology · 2026Article
- Prognostic impact and predictive model for early non-curative recurrence after liver resection for hepatocellular carcinoma: a retrospective cohort study.International journal of surgery (London, England) · 2026Article
- Development and Validation of an Individualized Prediction Model for Postoperative Late Recurrence After Hepatectomy for Hepatocellular Carcinoma (POLAR-HCC): A Multicenter Study.Annals of surgical oncology · 2025Article
- Non-contrast magnetic resonance imaging for detection of late recurrent hepatocellular carcinoma after curative treatment: a prospective multicenter comparison to contrast-enhanced computed tomography.Clinical and molecular hepatology · 2025Observational
- Revisiting the role of local treatments in the era of targeted therapy and immunotherapy for hepatocellular carcinoma.World journal of surgical oncology · 2025Review
- Article
- Chinese expert consensus on the diagnosis and treatment of hepatocellular carcinoma with microvascular invasion (2024 edition).Hepatobiliary surgery and nutrition · 2025Review
- Hepatocellular carcinoma: updates on epidemiology, surveillance, diagnosis and treatment.Clinical and molecular hepatology · 2025Review
- How to Predict Recurrence After Resection of Hepatocellular Carcinoma.Anticancer research · 2025Article
- Value of high frame rate contrast-enhanced ultrasound in predicting microvascular invasion of hepatocellular carcinoma.Insights into imaging · 2024Article
- Liver resection and transplantation in the era of checkpoint inhibitors.JHEP reports : innovation in hepatology · 2024Review
- Prognostic implications of CK19 positivity in patients with early recurrent hepatocellular carcinoma after hepatic resection undergoing transarterial chemoembolization.BMC gastroenterology · 2024Article
- Severity of microvascular invasion does matter in hepatocellular carcinoma prognosis: Editorial on "Classification of microvascular invasion of hepatocellular carcinoma: correlation with prognosis and magnetic resonance imaging".Clinical and molecular hepatology · 2024Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
28 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveThis study aims to validate a previously reported recurrence clinical risk score (CRS). SUMMARY OF BACKGROUND DATA: Salvage transplantation after hepatocellular carcinoma (HCC) resection is limited to patients who recur within Milan criteria (MC). Predicting recurrence patterns may guide treatment recommendations.
methodsAn international, multicenter cohort of R0 resected HCC patients were categorized by MC status at presentation. CRS was calculated by assigning 1 point each for initial disease beyond MC, multinodularity, and microvascular invasion. Recurrence incidences were estimated using competing risks methodology, and conditional recurrence probabilities were estimated using the Bayes theorem.
resultsFrom 1992 to 2015, 1023 patients were identified, of whom 613 (60%) recurred at a median follow-up of 50 months. CRS was well validated in that all 3 factors remained independent predictors of recurrence beyond MC (hazard ratio 1.5-2.1, all P < 0.001) and accurately stratified recurrence risk beyond MC, ranging from 19% (CRS 0) to 67% (CRS 3) at 5 years. Among patients with CRS 0, no other factors were significantly associated with recurrence beyond MC. The majority recurred within 2 years. After 2 years of recurrence-free survival, the cumulative risk of recurrence beyond MC within the next 5 years for all patients was 14%. This risk was 12% for patients with initial disease within MC and 17% for patients with initial disease beyond MC.
conclusionsCRS accurately predicted HCC recurrence beyond MC in this international validation. Although the risk of recurrence beyond MC decreased over time, it never reached zero.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.