Patient selection: intermediate stage HCC (Child-Pugh A or B cirrhosis, asymptomatic, large or multifocal, without macrovascular invasion or extrahepatic metastases)
Parameters relative to last TACE baseline:
(1) AST increase 25% from baseline
(2) radiologic tumor response
(3) increase in Child-Pugh score
percent AST increase =
= ((AST on followup) – (AST at baseline)) / (AST at baseline)
increase in Child-Pugh score =
= (followup CPS) – (baseline CPS)
|
Parameter
|
Finding
|
Points
|
|
AST increase
|
<= 25%
|
0
|
|
|
> 25%
|
4
|
|
radiologic tumor response
|
absent
|
1
|
|
|
present
|
0
|
|
increase in CP score
|
<= 0
|
0
|
|
|
1 point
|
1.5
|
|
|
>= 2 points
|
3
|
ART score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A patient with a low ART score after transarterial chemoembolization (TACE) may be a candidate for repeat TACE procedure.
• A patient with a higher ART score may be a candidate for an alternative therapy.
