The ART Score Is Not Effective to Select Patients for Transarterial Chemoembolization Retreatment in an Italian Series

被引:47
作者
Terzi, Eleonora [1 ]
Terenzi, Laura [1 ]
Venerandi, Laura [1 ]
Croci, Luca [1 ]
Renzulli, Matteo [2 ]
Mosconi, Cristina [2 ]
Allegretti, Giulia [1 ]
Granito, Alessandro [1 ]
Golfieri, Rita [2 ]
Bolondi, Luigi [1 ]
Piscaglia, Fabio [1 ]
机构
[1] Univ Bologna, Div Internal Med, Dept Digest Dis & Internal Med, St Orsola Malpighi Hosp, IT-40138 Bologna, Italy
[2] Univ Bologna, Div Radiol, Dept Diagnost & Prevent Med, St Orsola Malpighi Hosp, IT-40138 Bologna, Italy
关键词
ART score; Child-Pugh score; Multidisciplinary clinical approach; Retreatment; Transarterial chemoembolization; HEPATOCELLULAR-CARCINOMA; MANAGEMENT;
D O I
10.1159/000368007
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: The ART score (a point score for the assessment of retreatment with transarterial chemoembolization, TACE) has been recently developed in Austria to differentiate patients who may benefit from multiple sessions of TACE for hepatocellular carcinoma (HCC) treatment. The primary aim of the study was to test the validity of the ART score in an Italian study cohort. The secondary aims were to evaluate overall survival (OS) and clinical determinants of improved survival in patients treated with multiple TACE sessions. Methods: The ART score and the clinical outcome of 51 consecutive patients with HCC submitted to multiple TACE sessions from April 2002 to December 2009 were retrospectively analyzed. Results: Median OS was 26.0 months (95% confidence interval 18.4-33.6) with 1-, 3- and 5-year survival rates of 75, 33 and 11%, respectively). Thirty-three patients had an ART score of 0-1.5 and in 18 it was >= 2.5, but in our patient series, the ART score was not found to be a predictor of survival (p = 0.173). At univariate analysis, tumor extent (uni- vs. bilobar: 34.0 vs. 9.0 months; p < 0.001), Child-Pugh score before the second TACE (A vs. B7 vs. 88-9:26.0 vs. 16.0 vs. 5.0 months; p = 0.005) and Child-Pugh score increase between the first and second TACE (absent vs. + 1 point vs. + >= 2 points: 27.0 vs. 4.0 vs. 5.0 months; p < 0.001) were statistically.related with survival. At multivariate analysis, only Child-Pugh score increase remained a significant predictor of worse survival (p = 0.001, hazard rate = 11.6). Conclusions: The ART score was not found to work as an objective tool to guide TACE retreatment in our Italian patient series, only the Child-Pugh score increase was an independent predictor of a shorter survival. (C) 2014 S. Karger AG, Basel
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页码:711 / 716
页数:6
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