Fiche publication
Date publication
novembre 2014
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BRONOWICKI Jean-Pierre
Tous les auteurs :
Adhoute X, Penaranda G, Naude S, Raoul JL, Perrier H, Bayle O, Monnet O, Beaurain P, Bazin C, Pol B, Le Folgoc G, Castellani P, Bronowicki JP, Bourliere M
Lien Pubmed
Résumé
BACKGROUND: Transarterial chemoembolization (TACE) is the standard of care for intermediate stage hepatocellular carcinoma (HCC). But TACE is the most widely used treatment for HCC worldwide. No prognostic indices designed to select appropriate candidates for repeat conventional TACE has been enshrined in the guidelines. METHODS: From 01/2007 to 04/2012, 139 consecutive patients were treated for HCC by TACE, most of whom had an alcohol or viral-induced disease. Using a regression model, we determined from the prognostic variables of our population a score designed to help for repeat TACE and we validated in two cohorts. We compared it to the ART score. RESULTS: In the multivariate analysis, four prognostic factors were associated with OS: BCLC and AFP (>200 ng/mL) at baseline, increase in Child-Pugh score by 2 from baseline, and absence of radiological response. There were included in a score (ABCR) ranging from -3 to +6 that was correlated with survival. It identifies three groups with different survival. This score was validated in two different cohorts of 178 patients. ABCR score was better than ART score to distinguish between patients prognosis. CONCLUSION: 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 identify patients with dismal prognosis who may not benefit from further TACE sessions.
Référence
J Hepatol. 2014 Nov 21. pii: S0168-8278(14)00858-7
