title: A modified Japan Integrated Stage score for prognostic assessment in patients with hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Iwao
authors.initials: I
authors.lastname: Ikai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takayasu
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsuyama
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Kojiro
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ichida
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamaoka
mesh_terms: 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