Modified CLIP Score as a New Prognostic Index for Patients with Hepatocellular Carcinoma

Korean J Hepatol > Volume 12(2); 2006 > Article

The Korean Journal of Hepatology 2006;12(2): 209-220.

Modified CLIP Score as a New Prognostic Index for Patients with Hepatocellular Carcinoma

Seung Ho Han, M.D., Sang Young Han, M.D., Byoung Soung Go, M.D., Min Ji Kim, M.D., Jung Hyun Lee, M.D., Young Hun Koo, M.D., Seung Hoon Ryu, M.D., Jeong Hwan Cho, M.D., Jin Seok Jang, M.D., Jong Hoon Lee, M.D., Myung Hwan Roh, M.D., Seok Ryeol Choi, M.D., Joung Chel Choi, M.D.1, and Sung Wook Lee, M.D.

Department of Internal Medicine and Diagnostic Radiology1, Medical Sciences Research Institute of Gastroenterology, Dong-A University College of Medicine, Busan, Korea

ABSTRACT

Backgrounds/Aims: 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. (Korean J Hepatol 2006;12:209-220)

KeyWords: Carcinoma, hepatocellular; Neoplasm staging; Scoring methods; Outcome assessment, patient; Prognosis