How to STATE suitability and START transarterial chemoembolization in patients with intermediate stage hepatocellular carcinoma

Background & Aims We aimed to establish an objective point score to guide the decision for the first treatment with transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods 277 patients diagnosed with HCC and treated with transarterial treatments between 1/...

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Bibliographic Details
Published in:Journal of hepatology 2014-12, Vol.61 (6), p.1287-1296
Main Authors: Hucke, Florian, Pinter, Matthias, Graziadei, Ivo, Bota, Simona, Vogel, Wolfgang, Müller, Christian, Heinzl, Harald, Waneck, Fredrik, Trauner, Michael, Peck-Radosavljevic, Markus, Sieghart, Wolfgang
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Agents - administration & dosage
ART-score
C-Reactive Protein - metabolism
Carcinoma, Hepatocellular - metabolism
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - therapy
Chemoembolization, Therapeutic - methods
Cohort Studies
Female
Gastroenterology and Hepatology
HCC
Hepatocellular carcinoma
Humans
Liver Neoplasms - metabolism
Liver Neoplasms - mortality
Liver Neoplasms - therapy
Male
Middle Aged
Patient Selection
Prognosis
Regression Analysis
Retrospective Studies
Serum Albumin - metabolism
Survival Rate
TACE
Treatment Outcome
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Summary:Background & Aims We aimed to establish an objective point score to guide the decision for the first treatment with transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods 277 patients diagnosed with HCC and treated with transarterial treatments between 1/2002 and 12/2011 at the Medical Universities of Vienna (training cohort) and Innsbruck (validation cohort) were included. We investigated the impact of baseline liver function and tumour load on overall survival (OS, log-rank test) and developed a point score (STATE-score: Selection for TrAnsarterial chemoembolisation TrEatment) in the training-cohort (n = 131, Vienna) by using a stepwise Cox regression model. The STATE-score was externally validated in an independent validation cohort (n = 146, Innsbruck) and thereafter combined with the Assessment for Retreatment with TACE (ART)-score to identify patients who are (un)suitable for TACE. Results The STATE-score starts with the serum-albumin level (g/L), which is reduced by 12 points each, if the tumour load exceeds the up-to-7 criteria and/or C-reactive protein (CRP) levels are ⩾1 mg/dl (maximum reduction: 24 points). The STATE-score differentiated 2 groups (
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2014.07.002