title: Validation of a new prognostic staging system for hepatocellular carcinoma: a comparison of the biomarker-combined Japan Integrated Staging Score, the conventional Japan Integrated Staging Score and the BALAD Score.
abstract: OBJECTIVE
  The conventional Japan Integrated Staging (c-JIS) score has been reported to effectively stratify patients with hepatocellular carcinoma (HCC). Recently, two new staging systems, the biomarker-combined JIS (bm-JIS) score and the BALAD score, have been proposed. Both staging systems include three tumor markers: alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP and des-gamma-carboxy prothrombin specific for HCC. The aim of this study is to evaluate the performance of these three staging systems.
  
  
  METHODS
  A total of 1,173 HCC patients were included in this study. The stratification ability and prognostic predictive power were compared between these three staging systems.
  
  
  RESULTS
  These three staging systems effectively predicted the patient survival. When accounting for the best prognostic subgroup of each staging systems (i.e. score of 0), there were significant differences between the bm-JIS score and the BALAD score and, likewise, between the c-JIS score and the BALAD score. The likelihood ratio chi(2) test showed the highest value and the Akaike information criterion value was lowest in the bm-JIS score.
  
  
  CONCLUSIONS
  The bm-JIS score showed good stratification ability and was thus demonstrated to be a better predictor of the prognosis than the c-JIS score and the BALAD score, especially for the patients with a good prognosis.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kitai
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Seiji
authors.initials: S
authors.lastname: Haji
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
authors.forename: Hiroko
authors.initials: H
authors.lastname: Oka
authors.forename: Toshihito
authors.initials: T
authors.lastname: Seki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kasugai
authors.forename: Yo
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsunaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D005260:Female; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor