Yeonjung Ha1, Jung Bok Lee2, Ju Hyun Shim1, Kang Mo Kim1, Young-Suk Lim1, Hyun-Ki Yoon3, Yong Moon Shin3, Han Chu Lee4. 1. Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea. 2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea. 3. Department of Radiology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea. 4. Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea. hch@amc.seoul.kr.
Abstract
OBJECTIVES: To validate and reappraise the Assessment for Retreatment with Transarterial chemoembolization (ART) score comprising three parameters (>25 % increase in aspartate aminotransferase [AST], increase in Child-Pugh score and tumour response), determined prior to subsequent transarterial chemoembolization (TACE). METHODS: Enrolled patients were diagnosed with unresectable non-metastatic hepatocellular carcinoma and underwent multiple TACEs between June 2006 and December 2007 (N = 153). Subgroupings were classified according to the established cut-off (≤1.5 vs. ≥2.5). Survival analysis using the Kaplan-Meier curve was performed. RESULTS: The original ART score dichotomized patients according to their overall survival (P = 0.004). We found several patients who actually survived longer than others were assigned to a poor prognostic group due to the AST component. Parameter estimates for AST obtained from our analysis were much lower than the original version (0.5 vs. 2.1). We adjusted the component according to the value of our parameter estimates, and patients with >25 % AST increase received 1.0 point. After this modification, patients assigned to the favourable prognostic group were more likely to have a better survival outcome (median 23.9 vs. 12.2 months, P < 0.001). CONCLUSIONS: In hepatitis B virus-endemic regions, the ART score is valid and can better predict post-TACE survival after the AST component is modified. KEY POINTS: • The ART score was validated in a HBV-endemic region. • The modified ART score improved prognostic performance by reappraising the AST component. • The modified ART score helps physicians make decisions for further TACE.
OBJECTIVES: To validate and reappraise the Assessment for Retreatment with Transarterial chemoembolization (ART) score comprising three parameters (>25 % increase in aspartate aminotransferase [AST], increase in Child-Pugh score and tumour response), determined prior to subsequent transarterial chemoembolization (TACE). METHODS: Enrolled patients were diagnosed with unresectable non-metastatic hepatocellular carcinoma and underwent multiple TACEs between June 2006 and December 2007 (N = 153). Subgroupings were classified according to the established cut-off (≤1.5 vs. ≥2.5). Survival analysis using the Kaplan-Meier curve was performed. RESULTS: The original ART score dichotomized patients according to their overall survival (P = 0.004). We found several patients who actually survived longer than others were assigned to a poor prognostic group due to the AST component. Parameter estimates for AST obtained from our analysis were much lower than the original version (0.5 vs. 2.1). We adjusted the component according to the value of our parameter estimates, and patients with >25 % AST increase received 1.0 point. After this modification, patients assigned to the favourable prognostic group were more likely to have a better survival outcome (median 23.9 vs. 12.2 months, P < 0.001). CONCLUSIONS: In hepatitis B virus-endemic regions, the ART score is valid and can better predict post-TACE survival after the AST component is modified. KEY POINTS: • The ART score was validated in a HBV-endemic region. • The modified ART score improved prognostic performance by reappraising the AST component. • The modified ART score helps physicians make decisions for further TACE.
Authors: Florian Hucke; Wolfgang Sieghart; Matthias Pinter; Ivo Graziadei; Wolfgang Vogel; Christian Müller; Harald Heinzl; Fredrik Waneck; Michael Trauner; Markus Peck-Radosavljevic Journal: J Hepatol Date: 2013-09-03 Impact factor: 25.083
Authors: Wolfgang Sieghart; Florian Hucke; Matthias Pinter; Ivo Graziadei; Wolfgang Vogel; Christian Müller; Harald Heinzl; Michael Trauner; Markus Peck-Radosavljevic Journal: Hepatology Date: 2013-05-03 Impact factor: 17.425
Authors: Luigi Bolondi; Andrew Burroughs; Jean-François Dufour; Peter R Galle; Vincenzo Mazzaferro; Fabio Piscaglia; Jean Luc Raoul; Bruno Sangro Journal: Semin Liver Dis Date: 2013-02-08 Impact factor: 6.115
Authors: Aline Mähringer-Kunz; Arndt Weinmann; Irene Schmidtmann; Sandra Koch; Sebastian Schotten; Daniel Pinto Dos Santos; Michael Bernhard Pitton; Christoph Dueber; Peter Robert Galle; Roman Kloeckner Journal: BMC Cancer Date: 2018-04-27 Impact factor: 4.430