TY - JOUR
T1 - The effectiveness of ART score in selecting patients for transarterial chemoembolization retreatment a cohort study in Taiwan
AU - Tseng, Chi Lung
AU - Lai, Wei Jen
AU - Huang, Chun Jui
AU - Huang, Yi Hsiang
AU - Su, Chien Wei
AU - Lee, I. Cheng
AU - Tseng, Hsiou Shan
AU - Li, Chung Pin
AU - Lee, Rheun Chuan
AU - Lin, Han Chieh
AU - Chao, Yee
N1 - Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/11
Y1 - 2015/11
N2 - The major issue in selecting patients for transarterial chemoembolization (TACE) lies in determining the optimal number of TACE sessions that may benefit patients before switching to other therapies. This is often a subjective decision not based on any standardized protocol. The ART (Assessment for Retreatment with Transarterial chemoembolization) score was recently developed to determine patients who may benefit from multiple sessions of TACE for treatment of hepatocellular carcinoma. The primary aim of the study was to validate the ART score in a Taiwanese cohort. The secondary aims were to evaluate overall survival and clinical determinants of improved survival in patients treated with multiple TACE sessions. The ART score, clinical characteristics, and outcomes of 82 patients with hepatocellular carcinoma who received multiple TACE sessions at Taipei Veterans General Hospital from September 2007 to July 2013 were analyzed. Among the 82 patients evaluated, 69.5% (n=57) had an ART score of 0 to 1.5 and 34.1% (n=25) had a score of ≥2.5. The median overall survival was 23.1 months and the overall mortality rate was 62.2% (n=51). The ART score was not associated with survival (P=0.58). Multivariate Cox regression analysis revealed that tumor size >7.2 cm (hazard ratio 4.44, P<0.001), aspartate transaminase (AST) level above 95 IU/L (hazard ratio 2.18, P=0.02), AST increase more than 25% (hazard ratio 2.13, P=0.02), 2nd/1st (pre-TACE) alphafetoprotein ratio (hazard ratio 1.40, P=0.001), and lack of radiological response to TACE (hazard ratio 2.21, P=0.02) were independent clinical determinants of survival. The ART score was not found to be effective in selecting patients for TACE retreatment in our Taiwanese cohort. Large tumor size, high AST level, high 2nd/1st (pre-TACE) alpha-fetoprotein ratio, AST increase >25%, and lack of radiological response to TACE were independently associated with shorter survival after TACE therapy.
AB - The major issue in selecting patients for transarterial chemoembolization (TACE) lies in determining the optimal number of TACE sessions that may benefit patients before switching to other therapies. This is often a subjective decision not based on any standardized protocol. The ART (Assessment for Retreatment with Transarterial chemoembolization) score was recently developed to determine patients who may benefit from multiple sessions of TACE for treatment of hepatocellular carcinoma. The primary aim of the study was to validate the ART score in a Taiwanese cohort. The secondary aims were to evaluate overall survival and clinical determinants of improved survival in patients treated with multiple TACE sessions. The ART score, clinical characteristics, and outcomes of 82 patients with hepatocellular carcinoma who received multiple TACE sessions at Taipei Veterans General Hospital from September 2007 to July 2013 were analyzed. Among the 82 patients evaluated, 69.5% (n=57) had an ART score of 0 to 1.5 and 34.1% (n=25) had a score of ≥2.5. The median overall survival was 23.1 months and the overall mortality rate was 62.2% (n=51). The ART score was not associated with survival (P=0.58). Multivariate Cox regression analysis revealed that tumor size >7.2 cm (hazard ratio 4.44, P<0.001), aspartate transaminase (AST) level above 95 IU/L (hazard ratio 2.18, P=0.02), AST increase more than 25% (hazard ratio 2.13, P=0.02), 2nd/1st (pre-TACE) alphafetoprotein ratio (hazard ratio 1.40, P=0.001), and lack of radiological response to TACE (hazard ratio 2.21, P=0.02) were independent clinical determinants of survival. The ART score was not found to be effective in selecting patients for TACE retreatment in our Taiwanese cohort. Large tumor size, high AST level, high 2nd/1st (pre-TACE) alpha-fetoprotein ratio, AST increase >25%, and lack of radiological response to TACE were independently associated with shorter survival after TACE therapy.
UR - http://www.scopus.com/inward/record.url?scp=84979862615&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000001659
DO - 10.1097/MD.0000000000001659
M3 - Article
C2 - 26632677
AN - SCOPUS:84979862615
SN - 0025-7974
VL - 94
SP - e1659
JO - Medicine (United States)
JF - Medicine (United States)
IS - 47
ER -