A modified Japan Integrated Stage score for prognostic assessment in patients with hepatocellular carcinoma.
BACKGROUND
For patients with hepatocellular carcinoma (HCC), the selection of effective therapeutic options depends on a reliable prognostic assessment of both the tumor characteristics and liver impairment. This study sought to provide a modified Japan Integrated Stage (m-JIS) score to predict more accurately the survival of patients with HCC.


METHODS
We analyzed the records of 42,269 patients diagnosed with HCC that were registered between 1992 and 1999 in a nationwide Japanese database. The m-JIS score was calculated from the tumor-node-metastasis stage and the grade of liver damage as defined by the Liver Cancer Study Group of Japan. The predictive accuracy for patient survival based on the m-JIS score was compared with that determined by the modified Cancer of the Liver Italian Program (m-CLIP) score using the cross-validation method.


RESULTS
Patients were divided randomly into two groups, a training sample for construction of prediction models (n = 21,127 patients with 8,458 deaths) and a validation sample for assessment of those prediction models (n = 21,142 patients with 8,434 deaths). Both the m-JIS score and the m-CLIP score showed good discriminatory ability in the training sample. In the validation sample, the residuals of prediction based on the m-JIS score were smaller than those of the m-CLIP score (P < 0.0001).


CONCLUSIONS
The m-JIS scoring system had better predictive accuracy than the m-CLIP score system for survival of Japanese patients with HCC.
Ikai
Iwao
I
Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Takayasu
Kenichi
K
Omata
Masao
M
Okita
Kiwamu
K
Nakanuma
Yasuni
Y
Matsuyama
Yutaka
Y
Makuuchi
Masatoshi
M
Kojiro
Masamichi
M
Ichida
Takafumi
T
Arii
Shigeki
S
Yamaoka
Yoshio
Y
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends