[Modified CLIP score as a new prognostic index for patients with hepatocellular carcinoma].
OBJECTIVE
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.
Han
Seung Ho
SH
Department of Internal Medicine, Medical Sciences Research Institute of Gastroenterology, Dong-A University College of Medicine, Busan, Korea.
Han
Sang Young
SY
Go
Byoung Soung
BS
Kim
Min Ji
MJ
Lee
Jung Hyun
JH
Koo
Young Hun
YH
Ryu
Seung Hoon
SH
Cho
Jeong Hwan
JH
Jang
Jin Seok
JS
Lee
Jong Hoon
JH
Roh
Myung Hwan
MH
Choi
Seok Ryeol
SR
Choi
Joung Chel
JC
Lee
Sung Wook
SW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D020246:Venous Thrombosis / Q000150:complications; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins