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Gastroenterol Hepatol. 2017 Oct;40(8):515-524. doi: 10.1016/j.gastrohep.2017.05.009. Epub 2017 Jul 1.

The ART-SCORE is not an effective tool for optimizing patient selection for DEB-TACE retreatment. A multicentre Spanish study.

[Article in English, Spanish]

Author information

1
Department of Gastroenterology and Hepatology, Hospital de Cabueñes, Gijón, Asturias, Spain.
2
Liver Unit, Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
3
Liver Unit, Digestive Department, Ciberehd, Hospital General Universitario de Alicante, Alicante,, Spain.
4
Liver Transplantation Unit, Hospital Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.
5
Interventional Radiology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
6
Interventional and Vascular Radiological Unit, Hospital General Universitario de Alicante, Alicante, Spain.
7
Medical Oncology Department, Hospital Universitari i Policlínic La Fe, Valencia, Spain.
8
Digestive Department, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain.
9
Gastroenterology and Hepatology Department, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain.
10
Unit of Hepatology and Liver Transplantation, CIBERehd, IMIBIC, Hospital Universitario Reina Sofía, Córdoba, Spain.
11
Department of Gastroenterology, Complejo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur, Pontevedra, Spain.
12
Gastroenterology Department, Hospital Infanta Cristina, Badajoz, Spain.
13
Interventional Radiology, Medical Imaging Clinical Area, Hospital Universitari i Policlínic La Fe, Valencia, Spain.
14
Gastroenterology Department, Hospital Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.
15
Vascular Interventionist Radiology, Radiology Service, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
16
Liver Unit, Department of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. Electronic address: maria.varela.calvo@gmail.com.

Abstract

INTRODUCTION:

The appropriate selection of hepatocellular carcinoma (HCC) patients who are eligible for transarterial chemoembolization (TACE) remains a challenge. The ART score has recently been proposed as a method of identifying patients who are eligible or not for a second TACE procedure.

OBJECTIVE:

To assess the validity of the Assessment for Retreatment with TACE (ART) score in a cohort of patients treated with drug-eluting bead TACE (DEB-TACE).

SECONDARY OBJECTIVE:

to identify clinical determinants associated with overall survival (OS).

METHOD:

A retrospective, multicentre study conducted in Spain in patients with HCC having undergone two or more DEB-TACE procedures between January 2009 and December 2014. The clinical characteristics and OS from the day before the second DEB-TACE of patients with a high ART score (ART≥2.5) and a low ART score (ART 0-1) were compared. Risk factors for mortality were identified using Cox's proportional hazards model.

RESULTS:

Of the 102 patients included, 51 scored 0-1.5 and 51 scored ≥2.5. Hepatitis C was more frequent in patients scoring ≥2.5. Median OS from the day before the second DEB-TACE was 21 months (95% CI, 15-28) in the group scoring 0-1.5, and 17 months (95% CI, 10-25) in the group scoring ≥2.5 (P=0.3562). Platelet count and tumour size, but not the ART score, were independent baseline predictors of OS.

CONCLUSIONS:

The ART score is not suitable for guiding DEB-TACE retreatment according to Spanish clinical practice standards.

KEYWORDS:

Carcinoma hepatocelular; Estudio retrospectivo; Hepatocellular carcinoma; Liver neoplasm; Neoplasia hepática; Quimioembolización transarterial hepática; Retrospective study; Survival rate; Tasa de supervivencia; Transarterial liver chemoembolization

PMID:
28676199
DOI:
10.1016/j.gastrohep.2017.05.009
[Indexed for MEDLINE]

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