[Evaluation of predictive value of Okuda, TNM, CLIP and JIS staging systems for hepatocellular carcinoma patients].
OBJECTIVE
The aims of this study were to validate the prognostic value of the JIS score for HCC and to compare discriminatory ability and predictive power with other staging systems such as Okuda, TNM and CLIP.


METHODS
We analyzed the clinical records of 210 patients who were diagnosed as HCC from 2000 to 2002. Univariate and multivariate survival analyses were done to find out factors to affect survival. To validate prognostic value of those staging systems, survival curve was obtained and analyzed by the Kaplan-Meier's method, and to compare discriminatory ability and predictive power, Homogeneity LR X(2) test and AIC score were used.


RESULTS
The median survival was 19.5 months (19.1+/-14.9). The number of patients and 3-year survival rate for those staging systems were Okuda 1(126, 57.7%), 2(63, 9.0%) and 3(21, 0.0%) (p<0.001); TNM I (34, 63.1%), II (71, 59.4%), III (50, 22.4%), IV-A (6, 14.3%) and IV-B (1, 6.5%) (p<0.001); CLIP 0 (79, 68.5%), 1 (39, 34.2%), 2 (36, 16.7%), 3 (25, 20.0%), 4 (18, 5.1%), 5 (9, 11.1%) and 6 (4, 0.0%) (p<0.001) and JIS 0 (26, 78.9%), 1 (65, 65.3%), 2 (43, 21.9%), 3 (40, 25, 8.0%) and 5 (11, 2.0%)(p<0.001) in univariate analysis using Kaplan-Meier analysis. Homogeneity LR X(2) test showed more stratification power in JIS (Okuda, 102.8; TNM, 128.2; CLIP, 148.4 and JIS, 185.6) and AIC score showed superior predictive power in JIS system (Okuda, 1228.5; TNM, 1130.3; CLIP, 1117.1 and JIS, 1093.6).


CONCLUSIONS
The proposed JIS system is useful system to predict survival of HCC patients. The discriminate ability of the JIS score is much better than other staging systems and has better prognostic predictive power compared to other staging systems.
Lee
Sung Wook
SW
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Han
Sang Young
SY
Kim
Kyoung Tae
KT
Baek
Yang Hyun
YH
Koh
In Young
IY
Kim
Byoung Hee
BH
Park
Eun Hee
EH
Jang
Jin Seok
JS
Roh
Myung Hwan
MH
Choi
Jong Cheol
JC
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D016019:Survival Analysis