Background The “Assessment for Retreatment with TACE (transarterial chemoembolization)” (ART) score was developed to determine suitability for additional TACE treatment in patients with hepatocellular cancer - it utilises AST, absence of radiological response and Child-Pugh score following initial procedure. Those with a score of <1.5 gain benefit whereas those scoring ≥2.5 do not.
Aim To determine whether the ART score successfully predicted those patients who did and did not have repeat TACE for HCC.
Method Retrospective application of ART score to all patients undergoing TACE at the Royal Victoria Hospital, Belfast from March 2011 until July 2016.
Results 99 patients had TACE during the study period of whom 64 had a second TACE. The ART score was >2.5 in 22 of the 64 and therefore ART score would have excluded one third of retreatments. Of the 35 patients who just had a single TACE treatment, further TACE was not required in 11 (disease was stable in 8 patients, 2 underwent alternative treatments (1 transplant, 1 segmentectomy) and 1 refused). Of the remaining 24 patients not offered repeat TACE, 18 (75%) had an ART score of ≥2.5 and 6 were deemed unfit for other reasons (2 demonstrated disease progression not accounted for by ART score, 2 had significant comorbidities and 2 experienced complications following the initial procedure).
Conclusions The ART score successfully identified three quarters of patients deemed unsuitable for repeat TACE treatment. However, if applied ART would have excluded one third of patients who had a successful second TACE.