title: Preliminary analysis of a newly proposed prognostic scoring system (SLiDe score) for hepatocellular carcinoma.
abstract: BACKGROUND
  The long-term prognosis of hepatocellular carcinoma (HCC) remains poor and the prediction of survival is often difficult because of the limited liver function and frequent recurrence of HCC in most patients. Therefore, a prognostic classification of HCC should account for both tumor-related variables and liver function.
  
  
  METHODS
  The value of reported prognostic factors for HCC was assessed and a new prognostic classification was established called the 'SLiDe' scoring system (S, stage; Li, liver damage; De, des-gamma-carboxy prothrombin) using 'stage' and 'liver damage' of the recently revised 4th edition of the Japanese staging system edited by the Liver Cancer Study Group of Japan, and the serum level of des-gamma-carboxy prothrombin (DCP) in 177 patients with HCC.
  
  
  RESULTS
  Univariate analysis identified Child-Pugh stage, liver damage, tumor morphology, portal vein thrombosis, stage, serum level of alpha-fetoprotein (AFP), serum level of DCP, and initial treatment as significant prognostic factors. Of these, liver damage, stage, and serum level of DCP remained independent predictive factors of survival after multivariate prognostic analysis using the proportional hazards regression model. Therefore, a new prognostic scoring system (SLiDe scoring system) was derived that assigned a linear score (0/1/2/3) to these three covariates. This SLiDe scoring system was statistically a better model for predicting outcome in the present study population than the Cancer of the Liver Italian Program (CLIP) and the Japan Integrated Staging (JIS) scoring systems, as judged by the Akaike Information Criteria.
  
  
  CONCLUSIONS
  The SLiDe scoring system is useful for the assessment of the prognosis of patients with HCC as long as the Japanese staging system is used, although this uses parameters such as the indocyanine green retention test and DCP, which are not examined routinely in every part of the world. Therefore, the proposed classification should be further validated in other large study populations.
authors.affiliation: Second Department of Internal Medicine, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Omagari
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Honda
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kadokawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Kenji
authors.initials: K
authors.lastname: Hayashida
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mizuta
authors.forename: Ikuo
authors.initials: I
authors.lastname: Murata
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D016019:Survival Analysis