title: Evaluation of ART Scores for Repeated Transarterial Chemoembolization in Japanese Patients with Hepatocellular Carcinoma.
abstract: OBJECTIVE
  Transarterial chemoembolization (TACE) is recommended as a first-line therapy for hepatocellular carcinoma (HCC) patients ineligible for curative therapy and without portal invasion. The Assessment for Retreatment with TACE (ART) scoring system was recently proposed for identifying patients who would not show sufficient survival benefit from repeated TACE. We reevaluated the performance of ART in HCC patients treated in Japan, where selective TACE is commonly used.
  
  
  METHODS
  Between 2000 and 2013, 988 patients with HCC underwent TACE at Kinki University Hospital, and 627 received ≥2 sessions of TACE. Seventy-six patients who underwent ≥2 TACE sessions within 90 days were investigated for their performance of the ART score in the context of overall survival (OS).
  
  
  RESULTS
  Only 12% (76/627) of patients underwent ≥2 TACE sessions within 90 days. Of those, 52 patients showed a low ART score (0-1.5), and 24 had a high ART score (≥2.5); the median OS was 20.2 and 37.6 months, respectively (p = 0.8207).
  
  
  CONCLUSIONS
  The ART scoring system did not demonstrate a sufficiently predictive impact on OS among the patients who underwent ≥2 TACE sessions within 90 days. Application of the ART score should be carefully considered because differences in TACE procedures and post-TACE treatment can affect the results while evaluating OS.
authors.affiliation: Department of Gastroenterology and Hepatology, Faculty of Medicine, Kinki University, Osaka-Sayama, Japan.
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Arizumi
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Ueshima
authors.forename: Mina
authors.initials: M
authors.lastname: Iwanishi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Minami
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chishina
authors.forename: Masashi
authors.initials: M
authors.lastname: Kono
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kitai
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Inoue
authors.forename: Norihisa
authors.initials: N
authors.lastname: Yada
authors.forename: Satoru
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ida
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Sakurai
authors.forename: Naoshi
authors.initials: N
authors.lastname: Nishida
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kitano
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D015331:Cohort Studies; D003661:Decision Support Techniques; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D007564:Japan; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D019233:Retreatment; D015996:Survival Rate