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A modified Japan Integrated Stage score for prognostic assessment in patients with hepatocellular carcinoma |
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| Authors: | Iwao Ikai Kenichi Takayasu Masao Omata Kiwamu Okita Yasuni Nakanuma Yutaka Matsuyama Masatoshi Makuuchi Masamichi Kojiro Takafumi Ichida Shigeki Arii Yoshio Yamaoka |
| Affiliation: | (1) Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan;(2) Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan;(3) Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan;(4) Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, Ube, Japan;(5) Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan;(6) Department of Biostatistics, School of Health Sciences and Nursing University of Tokyo, Tokyo, Japan;(7) Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan;(8) Department of Pathology, Kurume University School of Medicine, Kurume, Japan;(9) Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan;(10) Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan;(11) Present address: The Liver Cancer Study Group of Japan, 403 Bear House, 40 Sanno-cho, Shogoin, Sakyo-ku, Kyoto 606-8392, Japan |
| 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 8458 deaths) and a validation sample for assessment of those prediction models (n = 21 142 patients with 8434 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. |
| Keywords: | TNM Stage degree of liver damage nationwide survey database Liver Cancer Study Group of Japan CLIP score |
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