A modified Japan Integrated Stage score for prognostic assessment in patients with hepatocellular carcinoma
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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.
Key words
TNM Stage degree of liver damage nationwide survey database Liver Cancer Study Group of Japan CLIP scorePreview
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