• Xavier Adhoute, Guillaume Penaranda, Sebastien Naude, Jean Luc Raoul, Herve Perrier, Olivier Bayle, Olivier Monnet, Patrick Beaurain, Christophe Bazin, Bernard Pol, Gaelle Le Folgoc, Paul Castellani, Jean Pierre Bronowicki, and Marc Bourlière.
• Department of Hepato-Gastroenterology, Hôpital Saint-Joseph Marseille, France.
• J. Hepatol. 2015 Apr 1; 62 (4): 855-62.

Background & AimsTransarterial chemoembolization (TACE) is the standard of care for intermediate stage hepatocellular carcinoma (HCC) and it is the most commonly used treatment for HCC worldwide. However, no prognostic indices, designed to select appropriate candidates for repeat conventional TACE, have been incorporated in the guidelines.MethodsFrom January 2007 to April 2012, 139 consecutive HCC patients, mainly with an alcohol- or viral-induced disease, were treated with TACE. Using a regression model on the prognostic variables of our population, we determined a score designed to help for repeat TACE and we validated it in two cohorts. We also compared it to the ART score.ResultsIn the multivariate analysis, four prognostic factors were associated with overall survival: BCLC and AFP (>200 ng/ml) at baseline, increase in Child-Pugh score by ⩾2 from baseline, and absence of radiological response. These factors were included in a score (ABCR, ranging from -3 to +6), which correlates with survival and identifies three groups. The ABCR score was validated in two different cohorts of 178 patients and proofed to perform better than the ART score in distinguishing between patients' prognosis.ConclusionsThe 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 identifies patients with dismal prognosis who may not benefit from further TACE sessions.Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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