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

Autor:	Pipa-Muñiz M; Department of Gastroenterology and Hepatology, Hospital de Cabueñes, Gijón, Asturias, Spain., Castells L; 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., Pascual S; Liver Unit, Digestive Department, Ciberehd, Hospital General Universitario de Alicante, Alicante,, Spain., Fernández-Castroagudín J; Liver Transplantation Unit, Hospital Universitario de Santiago, Santiago de Compostela, A Coruña, Spain., Díez-Miranda I; Interventional Radiology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Irurzun J; Interventional and Vascular Radiological Unit, Hospital General Universitario de Alicante, Alicante, Spain., Díaz-Beveridge R; Medical Oncology Department, Hospital Universitari i Policlínic La Fe, Valencia, Spain., Senosiaín M; Digestive Department, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain., Arenas J; Gastroenterology and Hepatology Department, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain., de la Mata M; Unit of Hepatology and Liver Transplantation, CIBERehd, IMIBIC, Hospital Universitario Reina Sofía, Córdoba, Spain., Turnes J; Department of Gastroenterology, Complejo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur, Pontevedra, Spain., Monge-Romero MI; Gastroenterology Department, Hospital Infanta Cristina, Badajoz, Spain., Pérez-Enguix D; Interventional Radiology, Medical Imaging Clinical Area, Hospital Universitari i Policlínic La Fe, Valencia, Spain., Bustamante-Schneider J; Digestive Department, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain., Otegui N; Gastroenterology and Hepatology Department, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain., Molina-Pérez E; Gastroenterology Department, Hospital Universitario de Santiago, Santiago de Compostela, A Coruña, Spain., Rodríguez-Menéndez JE; Vascular Interventionist Radiology, Radiology Service, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Varela M; Liver Unit, Department of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. Electronic address: maria.varela.calvo@gmail.com.
Jazyk:	English; Spanish; Castilian
Zdroj:	Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2017 Oct; Vol. 40 (8), pp. 515-524. Date of Electronic Publication: 2017 Jul 01.
DOI:	10.1016/j.gastrohep.2017.05.009
Abstrakt:	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. (Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.)
Databáze:	MEDLINE
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