Table 3.
Multivariable Analysis of Predictors of HCC Recurrence and Creation of the RETREAT Score
| Predictor | Multivariable HR (95% CI) | P Value | β Coefficient | RETREAT Pointsa |
|---|---|---|---|---|
| AFP at LT, ng/mL | ||||
| 0–20 | 1 [Reference] | NA | NA | 0 |
| 21–99 | 1.80 (1.05–3.10) | .03 | 0.59 | 1 |
| 100–999 | 2.56 (1.42–4.62) | .002 | 0.94 | 2 |
| ≥1000 | 4.45 (1.98–10.00) | <.001 | 1.49 | 3 |
| Microvascular invasion | 3.80 (2.23–6.47) | <.001 | 1.34 | 2 |
| Largest viable tumor diameter (cm) plus No. of viable tumorsb | ||||
| 0 | 1 [Reference] | NA | NA | 0 |
| 1.1–4.9 | 1.58 (0.73–3.39) | .25 | 0.45 | 1 |
| 5.0–9.9 | 2.69 (1.24–5.83) | .01 | 0.99 | 2 |
| ≥10 | 6.75 (2.55–17.88) | <.001 | 1.91 | 3 |
Abbreviations: AFP, α-fetoprotein level; HCC, hepatocellular carcinoma; HR, hazard ratio; LT, liver transplantation; NA, not applicable; RETREAT, risk estimation of tumor recurrence after transplant.
The RETREAT score is obtained by adding the total number of points scored in each of the 3 variables (range, 0–8). RETREAT score = 0 if a patient has an AFP of 0 to 20 ng/mL at LT, no microvascular invasion, and no viable tumor in the explant.
For example, if there are 3 lesions on explant, 2 viable lesions measuring 4 cm and 3 cm and a single completely necrotic lesion measuring 5 cm, the completely necrotic lesion is not counted, and the sum of the largest diameter of viable tumor (cm) and number of viable tumors would be 6 (4 = diameter of the largest lesion + 2 = No. of viable tumors). Explant largest viable tumor diameter + No. = 0 if no viable tumor is identified.