P-ART Score is a New Modification to Improve ART Score Predictive Accuracy for Patients with HCC Undergoing TACE.

Background: Predicting the prognosis of patients with HCC is challenging. Aim: To evaluate the Assessment for Retreatment with TACE (ART) score in predicting survival after TACE retreatment and the value of adding post-TACE thrombocytopenia in improving its accuracy (P-ART). Methods: Barcelona Clinic Liver Cancer (BCLC) stages A and B patients underwent TACE retreatment, and records were reviewed. Radiologic tumor response (RTR) after the first TACE was considered a partial response, while the absence of response is a stable or progressive disease. The one year overall survival (OS) from the second TACE was determined. Results: One hundred and sixty patients included 88.1% men, age 60.7±7.2 years, Child-Pugh class A&B cirrhosis (n=133 and 27, respectively), mostly hepatitis C (96.3%), with BCLC-A&B (n=74 and 86, respectively). RTR was present in 82 patients. Variables associated with poor OS: baseline lower serum albumin and platelet count, besides follow-up absent radiologic tumor response, an increase in AST >25%, an increase in Child-Pugh score, and a fall in platelet count fall ≥10,000/mL Conclusion: ART score could not identify patients who will benefit from TACE retreatment in intermediate-stage HCC patients, and the addition of platelet count reduction (P-ART) could improve its prognostic ability.