Xavier Adhoute1, Guillaume Penaranda2, Sebastien Naude3, Jean Luc Raoul4, Herve Perrier1, Olivier Bayle5, Olivier Monnet5, Patrick Beaurain5, Christophe Bazin6, Bernard Pol7, Gaelle Le Folgoc1, Paul Castellani1, Jean Pierre Bronowicki8, Marc Bourlière9. 1. Department of Hepato-Gastroenterology, Hôpital Saint-Joseph Marseille, France. 2. AlphaBio Laboratory Marseille, France. 3. Department of Hepato-Gastroenterology, Centre Hospitalier Universitaire de Nancy, France. 4. Department of Hepato-Gastroenterology and Digestive Oncology, Institut Paoli Calmette Marseille, France. 5. Department of Radiology, Hôpital Saint-Joseph Marseille, France. 6. Department of Radiology, Centre Hospitalier Universitaire de Nancy, France. 7. Department of Surgery, Hôpital Saint-Joseph Marseille, France. 8. INSERM U954, Université de Lorraine, CHU de Nancy, Vandoeuvre les Nancy, France; Department of Hepato-Gastroenterology, Centre Hospitalier Universitaire de Nancy, France. 9. Department of Hepato-Gastroenterology, Hôpital Saint-Joseph Marseille, France. Electronic address: mbourliere@hopital-saint-joseph.fr.
Abstract
BACKGROUND & AIMS: Transarterial chemoembolization (TACE) is the standard of care for intermediate stage hepatocellular carcinoma (HCC) and it is the most commonly used treatment for HCC worldwide. However, no prognostic indices, designed to select appropriate candidates for repeat conventional TACE, have been incorporated in the guidelines. METHODS: From January 2007 to April 2012, 139 consecutive HCC patients, mainly with an alcohol- or viral-induced disease, were treated with TACE. Using a regression model on the prognostic variables of our population, we determined a score designed to help for repeat TACE and we validated it in two cohorts. We also compared it to the ART score. RESULTS: In the multivariate analysis, four prognostic factors were associated with overall survival: BCLC and AFP (>200 ng/ml) at baseline, increase in Child-Pugh score by ⩾2 from baseline, and absence of radiological response. These factors were included in a score (ABCR, ranging from -3 to +6), which correlates with survival and identifies three groups. The ABCR score was validated in two different cohorts of 178 patients and proofed to perform better than the ART score in distinguishing between patients' prognosis. CONCLUSIONS: The ABCR score is a simple and clinically relevant index, summing four prognostic variables endorsed in HCC. An ABCR score ⩾4 prior to the second TACE identifies patients with dismal prognosis who may not benefit from further TACE sessions.
BACKGROUND & AIMS: Transarterial chemoembolization (TACE) is the standard of care for intermediate stage hepatocellular carcinoma (HCC) and it is the most commonly used treatment for HCC worldwide. However, no prognostic indices, designed to select appropriate candidates for repeat conventional TACE, have been incorporated in the guidelines. METHODS: From January 2007 to April 2012, 139 consecutive HCC patients, mainly with an alcohol- or viral-induced disease, were treated with TACE. Using a regression model on the prognostic variables of our population, we determined a score designed to help for repeat TACE and we validated it in two cohorts. We also compared it to the ART score. RESULTS: In the multivariate analysis, four prognostic factors were associated with overall survival: BCLC and AFP (>200 ng/ml) at baseline, increase in Child-Pugh score by ⩾2 from baseline, and absence of radiological response. These factors were included in a score (ABCR, ranging from -3 to +6), which correlates with survival and identifies three groups. The ABCR score was validated in two different cohorts of 178 patients and proofed to perform better than the ART score in distinguishing between patients' prognosis. CONCLUSIONS: The ABCR score is a simple and clinically relevant index, summing four prognostic variables endorsed in HCC. An ABCR score ⩾4 prior to the second TACE identifies patients with dismal prognosis who may not benefit from further TACE sessions.
Authors: L Cardarelli-Leite; A Hadjivassiliou; D Klass; J Chung; S G F Ho; H J Lim; P T W Kim; A Mujoomdar; D M Liu Journal: Curr Oncol Date: 2020-11-01 Impact factor: 3.677
Authors: Xavier Adhoute; Guillaume Penaranda; Jean Luc Raoul; Patrice Le Treut; Emilie Bollon; Jean Hardwigsen; Paul Castellani; Hervé Perrier; Marc Bourlière Journal: World J Hepatol Date: 2016-06-18