What was searched: Live PubMed queries on: global burden (GLOBOCAN 2022), MASLD/NAFLD and alcohol etiologic shift, non-cirrhotic NAFLD HCC risk, surveillance RCT + meta-analyses + harms modeling, BCLC 2022, AASLD 2023 and EASL 2025 guidelines, Milan criteria and Metroticket 2.0, SHARP, REFLECT, RESORCE, IMbrave150, HIMALAYA, CheckMate 9DW, exome/mutational landscape (Schulze 2015), TERT in NAFLD-HCC. All PMIDs verified via search + metadata retrieval this session.
Check next time: (1) Full-text primary of CheckMate 9DW global results (only the Japanese-subgroup paper with global interim HR was captured — locate/verify the global primary publication); (2) HIMALAYA long-term (4–5 yr) OS update; (3) adjuvant IO trials (IMbrave050 status after later analyses); (4) GALAD/biomarker validation studies for the surveillance page; (5) TACE+IO combination trials (EMERALD-1, LEAP-012) for locoregional page.
What changed: Completed all 17 canonical wiki pages (3,142 lines; all draft pending separate-session audit). Added 16 new pages and extended the seeded overview. Built literature/BIBLIOGRAPHY.md (105 unique papers with cited-by mappings), five landmark notes (Milan, SHARP, exome landscape, IMbrave150, BCLC 2022), guidelines/REGISTRY.md, statistics/STATISTICS.md (90 table rows), and the four-file patient-voice/ layer. Replaced OPEN-QUESTIONS.md with 26 stable tiered questions and a 12-row “Dots not yet connected” table. Rebuilt INDEX.md with counts, reading paths, live page statuses, and literature-layer links. Updated CONDITIONS-ROADMAP.md from seeded to built.
Live literature searches: PubMed E-utilities searches and record retrieval covered global/etiologic epidemiology; HBV vaccination and antivirals; post-HCV-cure risk; MASLD/non-cirrhotic HCC; alcohol burden; disparities; cirrhosis risk models and surveillance thresholds; ultrasound/AFP harms and utilization; abbreviated MRI and GALAD; LI-RADS CT/MRI/CEUS, biopsy seeding, and response imaging; BCLC/alternative staging and ALBI; exome, molecular/immune classes, CTNNB1 immune exclusion, single-cell atlases, and prospective genotyping; resection, portal hypertension, ablation, and adjuvant therapy; Milan/UCSF/Metroticket/downstaging/RETREAT; TACE/TARE/dosimetry/radiation and EMERALD-1/LEAP-012; systemic phase 3 and second-line trials; AASLD/EASL/APASL/JSH/KLCA-NCC/Chinese guidance; qualitative HCC experience, caregivers, preferences, transplant survivorship, PROs, and palliative care.
ClinicalTrials.gov: Queried API v2 live for HCC active studies and landmark trials. Thirty-eight unique NCT identifiers were written; all 38 returned HTTP 200 from their individual API records in final validation. The page records the 2026-08-28 registry-status snapshot.
Patient organizations: Direct retrieval succeeded for Liver Cancer UK, Blue Faery, and ILCA. American Liver Foundation returned HTTP 403, American Cancer Society HTTP 406, and Macmillan failed TLS verification with the session method; these are documented as access-limited and were not used for substantive claims.
Validation: All 17 pages contain required frontmatter, TL;DR, open questions, related pages, and references; every page is 153–231 lines. No broken local Markdown links or unsourced claim markers were found. All 105 unique wiki PMIDs are represented in the bibliography. A final live ESummary request resolved all 106 unique PMIDs present anywhere in the condition tree (the additional PMID is a superseded guideline in the registry). All 38 NCT records resolved.
Could not verify / follow up: (1) A PubMed-indexed global primary CheckMate 9DW paper was not recovered; only the Japanese subgroup paper reporting the global interim HR was used (PMID 42338692). (2) An exact current ESMO HCC guideline record was not recovered and was omitted. (3) The primary official 2022 Chinese guideline was represented through an indexed review (PMID 37124695), flagged in the registry. (4) Organization sites blocked above should be checked with a browser-capable audit. (5) This was the build session, not the independent citation-to-claim audit; pages intentionally remain draft and the roadmap is built, not audited.
What changed: Extended every one of the 17 canonical wiki pages in place without removing the prior verified content. Added quantitative evidence ledgers, effect sizes and confidence intervals, mechanism detail, trial-design boundaries, guideline divergences, and explicit two-sided controversies. Wiki depth increased from 3,142 to 3,964 lines; every page now carries at least 25 unique live-verified PubMed citations, except the trials page which carries 19 PubMed papers plus 38 live registry records. All pages remain draft because this was a build/deepening pass rather than the separately required audit.
PubMed work: Ran 136 page-specific PubMed E-utilities searches (eight per page) covering randomized trials, meta-analyses, mechanisms, guidelines, adverse effects, disparities, patient priorities, and unresolved questions. Retrieved full metadata/abstracts for 884 unique records and selected 215 new papers supported by the retrieved records. The wiki now cites 320 unique PMIDs, all represented once in literature/BIBLIOGRAPHY.md with page mappings.
ClinicalTrials.gov work: Re-fetched all 38 NCT identifiers individually from API v2 on 2026-08-30. Updated the status note and corrected the live snapshot: HIMALAYA (NCT03298451) and EMERALD-1 (NCT03778957) were active, not recruiting; CheckMate 9DW (NCT04039607), IMbrave050 (NCT04102098), and LEAP-012 (NCT04246177) were completed. Added planned enrollment/status context while explicitly separating registry completion from evidentiary positivity.
Literature layer: Expanded the bibliography from 105 to 321 unique papers: 320 cited by wiki pages plus the superseded 2018 EASL guideline retained in the registry. Strengthened statistics/STATISTICS.md from 90 to 129 table rows with etiologic attributable fractions, surveillance intervals, diagnostic performance, phase-3 biomarkers, downstaging, treatment, transplant rejection, disparities, and patient-preference estimates. Updated guidelines/REGISTRY.md with APASL systemic therapy 2024, the primary indexed China 2024 guideline, Korean modality components, OPTN/LI-RADS allocation context, and China/APASL supersession/overlay chains.
Research agenda: Sharpened OQ-2/3/4/6/7/11/14/15/17 into more explicit prospective or randomized designs, added quantified safety and biomarker thresholds, and expanded “Dots not yet connected” from 12 to 15 junctions.
Final validation: A fresh PubMed ESummary pass resolved all 321 PMIDs present anywhere in the condition tree, including the registry-only superseded EASL 2018 guideline; individual ClinicalTrials.gov API v2 requests resolved all 38 NCT identifiers. Static checks found 17/17 pages at 189–296 lines with draft status, current curation dates, bold TL;DR paragraphs, open questions, related-page links, and reference sections; every inline wiki PMID appears in its page reference list, all condition-tree PMIDs appear exactly once in the master bibliography, and no broken local Markdown links or unsourced claim markers remain.
Follow-up: A separate-session claim-to-citation audit is still required before any page can become curated. High-priority audit targets are numerical claims transcribed from abstracts, ePub/print year differences, current CheckMate 9DW global-primary publication availability, mature IMbrave050/EMERALD-1/LEAP-012 OS updates, and the continuing absence of an exact current PubMed-indexed ESMO HCC guideline recovered by these searches.
2026-08-30 — Independent citation and status audit¶
Scope and counts checked: Audited all 17 canonical wiki pages and all 12 literature artifacts. Re-fetched every identifier currently present in the condition tree in one final live pass: 329/329 unique PMIDs resolved through PubMed E-utilities and 39/39 unique NCT records resolved through ClinicalTrials.gov API v2. Checked 786 inline wiki PMID occurrences, 439 wiki reference entries, 328 one-line bibliography records, 122 statistics rows, all page structures/local links, and every recorded trial status. All 17 pages remained within the 150–400-line target and each carried at least 25 live-verified PMID/NCT records in its evidence set.
Substantive stale-evidence errors found and fixed (5): (1) replaced reliance on the CheckMate 9DW Japanese subgroup with the now-indexed global phase 3 report (Yau 2025, PMID 40349714), including median OS, non-proportional early/late hazards, and treatment-attributed deaths; (2) replaced the outdated “IMbrave050 durability unresolved” wording with the 2026 update showing nonsustained RFS benefit and an unsupported adjuvant benefit–risk profile (Yopp 2026, PMID 41580093); (3) recovered and added the exact current ESMO 2025 HCC guideline (Vogel 2025, PMID 39986353) and supersession chain; (4) updated the post-immunotherapy sequencing gap to incorporate new observational LEVIATHAN and reconstructed-IPD evidence while retaining the dated absence of randomized sequence trials (PMID 41321927; PMID 42128139); and (5) replaced the static abbreviated-MRI mortality-trial absence with the positively stated, dated fact that the 4,700-person PREMIUM mortality RCT is recruiting (NCT05486572; PMID 41624484).
Citation/reference errors found and fixed: Corrected three wrong journal assignments (PMID 35945907, PMID 40058162, PMID 36216350), the PubMed author form for PMID 27511114, the claim-to-source grouping for HCC's approximately 90% share of primary liver cancers, and the under-supported quoted UCSF size criteria by adding the directly matching live record (PMID 12200775). Normalized nine additional PubMed journal qualifiers in page references, repaired the bibliography cited-by mapping for PMID 38126757, removed an unused bibliography-only SBRT commentary, and revalidated all author/year/journal combinations with zero remaining metadata mismatches.
Absence searches rerun: Targeted live searches covered direct first-line IO-combination comparisons, randomized post-IO sequencing, non-cirrhotic MASLD surveillance mortality, abbreviated-MRI mortality trials, transplant bridging randomization, CheckMate 9DW, IMbrave050, and current ESMO guidance. The first-line head-to-head, randomized post-IO, and non-cirrhotic MASLD mortality gaps remain genuine as of 2026-08-30 and are now written as dated positive evidence-gap statements rather than undated absences.
Patient-voice/web audit: Re-fetched every recorded public organization URL. Liver Cancer UK, Blue Faery, ILCA, and Macmillan returned HTTP 200; Macmillan was moved from access-limited to verified. American Liver Foundation (HTTP 403) and American Cancer Society (HTTP 406) remain access-limited and are not used for substantive claims.
What remains flagged: No unresolved verification marker, citation mismatch, broken local link, or substantive page issue remains. Open research gaps remain explicitly labeled: PREMIUM has no outcome data and is estimated to complete in 2031; no direct randomized ranking of current first-line IO combinations or prospective randomized post-IO sequence was found; non-cirrhotic MASLD surveillance lacks prospective mortality validation; EMERALD-1/LEAP-012 OS maturity and future guideline incorporation require continued watch. The two access-limited organization sites above remain retrieval limitations only.
Status outcome: Promoted all 17 wiki pages from draft to curated, marked every literature-layer artifact audited in the index, and advanced CONDITIONS-ROADMAP.md from built to audited.