Evidence map›Paper›PMID 40067686›Full record

ArticleHepatology (Baltimore, Md.)2025

A prospective multicenter validation of RETREAT for posttransplantation HCC recurrence prediction.

P Jonathan Li, Parissa Tabrizian, Darine Daher, Felipe Gaviria, Veeral Ajmera, Eleazar E Montalvan-Sanchez, Julio A Gutierrez, Kali Zhou, Fanny Delebecque, Nicole Garcia and 12 more

Abstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Hepatology (Baltimore, Md.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

P Jonathan LiDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.
Parissa TabrizianLiver Transplant and Hepatobiliary Surgery, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Darine DaherDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Felipe GaviriaDepartment of Surgery, HPB Surgical Oncology and Multi-Organ Transplant Program, University Health Network, University of Toronto, Ontario, Canada.
Veeral AjmeraDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California San Diego, La Jolla, California, USA.
Eleazar E Montalvan-SanchezDepartment of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Julio A GutierrezScripps Center for Organ Transplantation, La Jolla, California, USA.
Kali ZhouDepartment of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Fanny DelebecqueDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California San Diego, La Jolla, California, USA.
Nicole GarciaDepartment of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Bethany BarrickScripps Center for Organ Transplantation, La Jolla, California, USA.
Christopher WongDepartment of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Lauren NephewDepartment of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
John HoldenDepartment of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Shravan DaveDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California San Diego, La Jolla, California, USA.
Gabriel T SchnickelDepartment of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA.
Nicole E RichDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Sander S FlormanLiver Transplant and Hepatobiliary Surgery, Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Gonzalo SapisochinDepartment of Surgery, HPB Surgical Oncology and Multi-Organ Transplant Program, University Health Network, University of Toronto, Ontario, Canada.
Francis YaoDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.
Amit G SingalDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Neil MehtaDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.

Funding

UCSF Liver Core CenterP30DK026743 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Holger Willenbring · 1986 to 2026
$30.7M
NRSA Training CoreTL1TR001871 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SOMSOUK, MA · 2016 to 2025
$10.1M
Precision Risk Stratification and Screening for HCC among Patients with Indeterminate Liver NodulesU01CA283935 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI HOSHIDA, YUJIN, SINGAL, AMIT · 2023 to 2025
$3.9M
Multi-level Evaluation of Racial/ethnic Disparities in Liver Disease OutcomesR01CA256977 · NCI · BAYLOR COLLEGE OF MEDICINE · PI KANWAL, FASIHA, SINGAL, AMIT · 2021 to 2025
$3.0M
NCATS NIH HHS TL1 TR001871NCI NIH HHS R01 CA256977NCI NIH HHS U01 CA283935NIDDK NIH HHS P30 DK026743
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe RETREAT(Risk Estimation of Tumor REcurrence After Transplant) score is a simple risk stratification tool for postliver transplantation (LT) HCC recurrence that has been validated in retrospective cohort studies. A prospective, multicenter study is needed to further demonstrate accuracy especially given the evolving clinical demographics and HCC transplant practice. Our aim is to validate and compare the RETREAT score to other post-LT HCC recurrence risk scores in a contemporary, prospective cohort of patients. APPROACH AND

resultsWe prospectively enrolled patients with HCC who underwent LT from 8 centers between 2018 and 2022. The primary outcome was post-LT recurrence-free survival. Secondary outcomes included post-LT and post-recurrence survival. Model performance, determined using the concordance index, Akaike information criterion, integrated Brier score, and calibration, was compared to that of other established risk scores.We included 1166 patients with HCC who underwent LT, of which 78 (6.7%) had post-LT HCC recurrence after a median follow-up time of 2.2 years (IQR 1.2-3.2). The median RETREAT score was 4 (IQR 3-5) in patients with post-LT HCC recurrence and 1 (IQR 1 - 2) in patients without. Those with a RETREAT score of 0, 3, and 5+ had a 99.4%, 84.1%, and 55.6% recurrence-free survival, respectively, at 3 years post-LT. The RETREAT score was also able to stratify post-LT overall and postrecurrence survival. The RETREAT score's concordance index was 0.81 (95% CI: 0.77-0.85) and outperformed the MORAL and RELAPSE scores across multiple metrics.

conclusionsThe RETREAT score retains high accuracy for predicting post-LT HCC recurrence, further supporting RETREAT-guided post-LT HCC surveillance and care.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsLiver TransplantationNeoplasm Recurrence, LocalAgedFemaleHumansMaleMiddle AgedProspective StudiesRisk Assessmenthepatocellular carcinomaprognostic risk scoretransplant oncology

Identifiers

PMID40067686
PMCPMC12355349

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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.