Korean J Hepatol.  2006 Jun;12(2):209-220.

Modified CLIP Score as a New Prognostic Index for Patients with Hepatocellular Carcinoma

Affiliations
  • 1Department of Internal Medicine, Medical Sciences Research Institute of Gastroenterology, Dong-A University College of Medicine, Busan, Korea. sunglee@dau.ac.kr
  • 2Department of Diagnostic Radiology, Medical Sciences Research Institute of Gastroenterology, Dong-A University College of Medicine, Busan, Korea.

Abstract

BACKGROUNDS/AIMS: The prognosis of cirrhotic patients with hepatocellular carcinoma (HCC) depends on both residual liver function and tumor characteristics. The aims of this study was to construct a new prognostic index for HCC patients: the modified CLIP score, and to compare its discriminatory ability and predictive power with those of the CLIP score that is currently the most commonly used integrated staging score in patients of HCC. METHODS: A retrospective analysis of 237 cases of HCC diagnosed at Dong-A university hospital was performed. Prognostic analysis was performed for single variables by estimating survival distributions with the Kaplan-Meier's method, and statistically compared by the log-rank test. RESULTS: Patients had a mean age of 57.5 years and were predominantly males (79.7%). The overall median survival period was 25.7 months. It was correlated to ascites, portal vein thrombosis, AFP, tumor size, and Child-Pugh classification. The median survival period was 41.0, 25.2, 13.8, 13.4, and 6.5 months for CLIP scores 0, 1, 2, 3, and 4 to 6, respectively (P<0.001), and 42.1, 34.0, 25.7, 14.0, and 6.8 months for modified CLIP scores 0, 1, 2, 3, and 4 to 6, respectively (P<0.001). The Kaplan-Meier's curve showed that the modified CLIP score had additional explanatory power above that of the CLIP score. CONCLUSIONS: The modified CLIP score, compared with the CLIP score, particularly in the score 2- to 3- patient groups of HCC, had greater discriminant ability and survival predictive power, but was not able to discriminate 4- to 6- patient group.

Keyword

Carcinoma, hepatocellular; Neoplasm staging; Scoring methods; Outcome assessment, patient; Prognosis

MeSH Terms

alpha-Fetoproteins/analysis
Venous Thrombosis/complications
Survival Analysis
Prognosis
Neoplasm Staging
Middle Aged
Male
Liver Neoplasms/complications/mortality/*pathology
Liver Cirrhosis/complications
Humans
Female
Carcinoma, Hepatocellular/complications/mortality/*pathology
Aged, 80 and over
Aged
Adult
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