{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T13:30:22Z","timestamp":1776778222286,"version":"3.51.2"},"reference-count":20,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many centers screen all recipients for hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). This approach may add substantial burdens of cost, incidental findings, and, depending on the imaging modality, radiation and\/or contrast\u2010induced complications. We created simple criteria to help clinicians identify low\u2010risk patients in whom post\u2010LT surveillance offers marginal utility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Criteria were developed retrospectively using adults with HCC who underwent LT at the University of Cincinnati from 2000 to 2014. Low\u2010risk patients had none of the following at LT: (1) outside Milan criteria, (2) alpha\u2010fetoprotein \u2265\u2009200\u2009ng\/mL, (3) prior hepatectomy with vascular invasion or unknown histology, and (4) any vascular invasion or &gt;\u20093 lesions on explant, or extrahepatic extension noted intraoperatively. Criteria were retrospectively validated in adults transplanted for HCC at Mass General Brigham from 2015 to 2023 and prospectively assessed at Cincinnati where low\u2010risk patients received no post\u2010LT surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 132 development cohort patients, 14 (10.6%) developed recurrent HCC at a median of 2.0 (range 0.1\u20139.7) years. Only 1 (1.1%) of the 91 (68.9%) patients deemed low\u2010risk by the proposed criteria developed recurrence compared to 13 (31.7%) of the high\u2010risk patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the validation cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009188), recurrence occurred in 1 (0.9%) of 114 (60.6%) low\u2010risk and 16 (21.6%) high\u2010risk patients. In the prospective cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955), none of 42 (76.4%) low\u2010risk patients developed recurrence versus 3 (23.1%) high\u2010risk patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011) after 8.0 (0.1\u20139.4) years of follow\u2010up. The criteria performed similarly to the RETREAT score 0 across cohorts (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009375) in identifying patients without recurrence as low\u2010risk (negative predictive value 99.2% vs. 97.1%) but required screening significantly fewer patients (34.1% vs. 81.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These prospectively validated criteria offer clinicians a practical tool for easily and accurately determining which patients would benefit from surveillance for HCC recurrence after LT. Surveillance targeting only high\u2010risk patients could reduce the harms of excess screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71428","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T13:40:09Z","timestamp":1764423609000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Screening for Hepatocellular Carcinoma Recurrence After Liver Transplantation: Prospective Validation of Binary Criteria"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5080-1522","authenticated-orcid":false,"given":"Wesley","family":"Dixon","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham &amp; Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8293-7005","authenticated-orcid":false,"given":"Shaun","family":"Chandna","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Olive View\u2010UCLA Medical Center  Sylmar California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan S.","family":"Sack","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham &amp; Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meagan","family":"Gray","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology The University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina N.","family":"Brown","sequence":"additional","affiliation":[{"name":"Gastrointestinal Associates, Inc.  Jenkintown Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sampath","family":"Poreddy","sequence":"additional","affiliation":[{"name":"Gastroenterology Division Creighton University School of Medicine  Omaha Nebraska USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Ha","sequence":"additional","affiliation":[{"name":"Gastrohealth  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6255-2807","authenticated-orcid":false,"given":"Michael R.","family":"Schoech","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen D.","family":"Zucker","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy Brigham &amp; Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003174"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14205114"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001086"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12175457"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.12.025"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.05.052"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.09.025"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27787"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001966"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.08.020"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2022.100445"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.5116"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14549"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000001297"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14030630"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000466"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/LVT.0000000000000590"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13194882"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16050927"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71428","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.71428","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71428","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T12:27:39Z","timestamp":1771331259000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,29]]},"references-count":20,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/cam4.71428"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71428","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,29]]},"assertion":[{"value":"2025-05-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71428"}}