SIMAP500: A novel risk score to identify recipients at higher risk of hepatocellular carcinoma recurrence following liver transplantation

Table 3 Univariate and multivariate analysis of predictors of hepatocellular carcinoma recurrence following liver transplantation, n (%)

	No-recurrence (n = 209)	Recurrence (n = 25)	Univariate		Multivariate
			HR (LL-UL 95%CI)	P value	HR (LL-UL 95%CI)	P value
LT era
2010-2013	64 (30.6)	7 (28.0)	2.146 (0.446-10.330)	0.341
2014-2017	106 (50.7)	16 (64.0)	2.700 (0.621-11.745)	0.185
2018-2020	39 (18.7)	2 (8.0)	1.000
RETREAT score
≤ 3	135 (68.2)	8 (32.0)	1.000		1.000
> 3	63 (31.8)	17 (68.0)	4.403 (1.900-10.206)	0.001	1.011 (0.315-3.238)	0.986
Donor type
DBD	110 (52.6)	16 (64.0)	1.475 (0.652-3.337)	0.351
DCD	99 (47.4)	9 (36.0)	1.000
Listing to transplant interval (months)
< 1	45 (21.5)	9 (36.0)	1.000
1-3	82 (39.2)	6 (24.0)	0.414 (0.147-1.164)	0.095
> 3	82 (39.2)	10 (40.0)	0.692 (0.281-1.704)	0.423
Within Milan criteria	199 (95.2)	24 (96.0)	1.359 (0.184-10.046)	0.764
Within United Kingdom criteria	204 (97.6)	25 (100.0)	0.048 (7.721 × 10-7–2965.3)	0.589
Tumour largest size (cm)
≤ 5	203 (98.5)	23 (95.8)	1.000
> 5	3 (1.5)	1 (4.2)	2.380 (0.321-17.629)	0.396
Number of tumours
≤ 3	200 (96.6)	25 (100.0)	1.000
> 3	7 (3.4)	0 (0.0)	0.047 (0.000-519.138)	0.520
AFP-listing
< 100	185 (89.8)	20 (80.0)	1.000		1.000
100-500	18 (8.7)	3 (12.0)	1.468 (0.436-4.941)	0.536	0.723 (0.201-2.596)	0.619
> 500	3 (1.5)	2 (8.0)	5.170 (1.207-22.138)	0.027	8.958 (1.689-47.503)	0.010
Bridging	117 (56.0)	21 (84.0)	3.707 (1.272-10.801)	0.016
The trend of size between listing and LT on imaging
Decrease	94 (52.5)	7 (29.2)	1.000		1.000
Same	20 (11.2)	2 (8.3)	1.243 (0.258-5.986)	0.786	0.851 (0.153-4.738)	0.854
Increase	65 (36.3)	15 (62.5)	3.097 (1.263-7.598)	0.014	1.180 (0.392-3.554)	0.768
The trend of AFP between listing and LT
Decrease	57 (29.1)	4 (16.0)	1.000
Same	94 (48.0)	11 (44.0)	1.697 (0.540-5.329)	0.365
Increase	45 (23.0)	10 (40.0)	2.912 (0.913-9.284)	0.071
Size change between explant viable largest tumour and listing largest tumour
Decrease	119 (57.5)	7 (28.0)	1.000
Same	22 (10.6)	3 (12.0)	2.090 (0.540-8.082)	0.285
Increase	66 (31.9)	15 (60.0)	3.842 (1.566-9.424)	0.003
Explant viable tumour number
≤ 3	152 (84.4)	18 (75.0)	1.000
> 3	28 (15.6)	6 (25.0)	1.889 (0.750-4.759)	0.177
Microvascular invasion	98 (46.9)	21 (84.0)	6.087 (2.089-17.735)	0.001	3.014 (0.697-13.032)	0.140
Macrovascular invasion	8 (3.8)	6 (24.0)	5.320 (2.121-13.348)	< 0.001	2.888 (0.907-9.198)	0.073
Satellite nodules	11 (5.3)	6 (24.0)	4.728 (1.887-11.845)	0.001	3.673 (1.204-11.210)	0.022
Tumor grade
Complete necrosis	31 (15.0)	1 (4.0)	0.235 (0.032-1.736)	0.156
Well-differentiated	48 (23.2)	2 (8.0)	0.311 (0.073-1.320)	0.113
Moderately differentiated	112 (54.1)	11 (44.0)	0.673 (0.305-1.481)	0.325
Poorly differentiated	16 (7.7)	11 (44.0)	7.805 (3.536-17.230)	< 0.001	3.727 (1.428-9.730)	0.007

AFP: Alpha fetoprotein; DCD: Donation after circulatory death; DBD: Donation after brain stem death; RETREAT: Risk Estimation of Tumor Recurrence After Transplant; LT: Liver transplantation.