RETREAT Score Accurately Predicts the Long-Term Risk of HCC Recurrence After Liver Transplantation: A Single-Center...

Area of Science:

• Hepatology
• Transplant Surgery
• Oncology

Background:

• Hepatocellular carcinoma (HCC) recurrence post-liver transplantation (LT) remains a significant clinical challenge.
• Accurate prediction of HCC recurrence is crucial for patient management and improving outcomes.

Purpose of the Study:

• To validate and apply the Risk Estimation of Tumor Recurrence After Transplant (RETREAT) score for predicting HCC recurrence and survival.
• To assess the RETREAT score's performance in a large cohort of LT recipients with HCC.

Main Methods:

• Retrospective analysis of 298 adult patients undergoing LT for HCC between January 2000 and July 2022.
• Application of the RETREAT score to stratify patients into low-, medium-, and high-risk groups for HCC recurrence.
• Kaplan-Meier analysis and competitive risk analysis to evaluate recurrence-free survival (RFS) and overall survival (OS).

Main Results:

• During a median follow-up of 64 months, 19% of patients experienced HCC recurrence.
• 5-year RFS rates were 93% (low-risk), 78% (medium-risk), and 58% (high-risk) (p < 0.001).
• The RETREAT score significantly predicted HCC recurrence (HR 2.3 for medium, HR 6.4 for high risk) and was associated with overall survival in the high-risk group (HR 2.5).

Conclusions:

• The RETREAT score is a validated tool for predicting HCC recurrence risk after LT.
• Stratification by RETREAT score aids in identifying patients at higher risk of recurrence and mortality.
• This score can inform clinical decision-making and post-transplant surveillance strategies for HCC patients.