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.
Similar content being viewed by others
References
FX Bosch J Ribes J Borras (1999) ArticleTitleEpidemiology of primary liver cancer Semin Liver Dis 19 271–85 Occurrence Handle10518307 Occurrence Handle1:STN:280:DyaK1Mvks1Gktw%3D%3D
I Ikai S Arii T Ichida K Okita M Omata M Kojiro et al. (2005) ArticleTitleReport of the 16th follow-up survey of primary liver cancer Hepatol Res 32 163–72 Occurrence Handle16024288 Occurrence Handle10.1016/j.hepres.2005.04.005
InstitutionalAuthorNameThe Liver Cancer Study Group of Japan (1990) ArticleTitlePrimary liver cancer in Japan. Clinicopathologic features and results of surgical treatment Ann Surg 211 277–87
InstitutionalAuthorNameThe Liver Cancer Study Group of Japan (1994) ArticleTitlePredictive factors for long term prognosis after partial hepatectomy for patients with hepatocellular carcinoma Cancer 74 2772–80 Occurrence Handle10.1002/1097-0142(19941115)74:10<2772::AID-CNCR2820741006>3.0.CO;2-V
S Arii Y Yamaoka S Futagawa K Inoue K Kobayashi M Kojiro et al. (2000) ArticleTitleResults of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. The Liver Cancer Study Group of Japan Hepatology 32 1224–9 Occurrence Handle11093728 Occurrence Handle1:STN:280:DC%2BD3M%2FntFegsQ%3D%3D Occurrence Handle10.1053/jhep.2000.20456
I Ikai S Arii M Kojiro T Ichida M Makuuchi Y Matsuyama et al. (2004) ArticleTitleRe-evaluation of prognostic factors for survival after liver resection in patients with hepatocellular carcinoma in a Japanese nationwide survey Cancer 101 796–802 Occurrence Handle15305412 Occurrence Handle10.1002/cncr.20426
Live Cancer Study Group of Japan. General rules for the clinical and pathological study of primary liver cancer. 2nd English ed. Tokyo: Kanehara; 2003
S Wildi BC Pestalozzi L McCormack PA Clavien (2004) ArticleTitleCritical evaluation of the different staging systems for hepatocellular carcinoma Br J Surg 91 400–8 Occurrence Handle15048738 Occurrence Handle1:STN:280:DC%2BD2c7lsVWgsg%3D%3D Occurrence Handle10.1002/bjs.4554
InstitutionalAuthorNameThe Cancer of the Liver Italian Program (CLIP) investigators (1998) ArticleTitleA new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients Hepatology 28 751–5 Occurrence Handle10.1002/hep.510280322
JM Llovet C Bru J Bruix (1999) ArticleTitlePrognosis of hepatocellular carcinoma: the BCLC staging classification Semin Liver Dis 19 329–38 Occurrence Handle10518312 Occurrence Handle1:STN:280:DyaK1Mvks1Grsg%3D%3D Occurrence Handle10.1055/s-2007-1007122
TW Leung AM Tang B Zee WY Lau PB Lai KL Leung et al. (2002) ArticleTitleConstruction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study based on 926 patients Cancer 94 1760–9 Occurrence Handle11920539 Occurrence Handle10.1002/cncr.10384
M Kudo H Chung Y Osaki (2003) ArticleTitlePrognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging score (JIS score) J Gastroenterol 38 207–15 Occurrence Handle12673442 Occurrence Handle10.1007/s005350300038
M Kudo H Chung S Haji Y Osaki H Oka T Seki et al. (2004) ArticleTitleValidation of a new prognostic staging system for hepatocellular carcinoma: the JIS score compared with the CLIP score Hepatology 40 1396–405 Occurrence Handle15565571 Occurrence Handle10.1002/hep.20486
K-Y Liang SL Zeger (1986) ArticleTitleLongitudinal data analysis using generalized linear models Biometrika 73 13–22 Occurrence Handle10.2307/2336267
K Okuda T Ohtsuki H Obata M Tomimatsu N Okazaki H Hasegawa et al. (1985) ArticleTitleNatural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients Cancer 56 918–28 Occurrence Handle2990661 Occurrence Handle1:STN:280:BiqB2MvivFE%3D Occurrence Handle10.1002/1097-0142(19850815)56:4<918::AID-CNCR2820560437>3.0.CO;2-E
InstitutionalAuthorNameInternational Union (2002) Against Cancer. TNM classification of malignant tumor EditionNumber6th ed Wiley Hoboken, NJ
M Makuuchi JB Belghiti G Belli ST Fan JY Lau B Ringe et al. (2003) ArticleTitleIHPBA concordant classification of primary liver cancer: working group report J Hepatobiliary Pancreat Surg 10 26–30 Occurrence Handle12918454
H Lau K Man ST Fan WC Yu CM Lo J Wong (1997) ArticleTitleEvaluation of preoperative hepatic function in patients with hepatocellular carcinoma undergoing hepatectomy Br J Surg 84 1255–9 Occurrence Handle9313707 Occurrence Handle1:STN:280:ByiH2MfptlY%3D Occurrence Handle10.1002/bjs.1800840917
InstitutionalAuthorNameThe Cancer of the Liver Italian Program (CLIP) Investigators (2000) ArticleTitleProspective validation of the CLIP score: a new prognostic system for patients with cirrhosis and hepatocellular carcinoma Hepatology 31 840–5 Occurrence Handle10.1053/he.2000.5628
I Levy M Sherman InstitutionalAuthorNameLiver Cancer Study Group of the University of Toronto (2002) ArticleTitleStaging of hepatocellular carcinoma: assessment of the CLIP, Okuda, and Child-Pugh staging systems in a cohort of 257 patients in Toronto Gut 50 881–5 Occurrence Handle12010894 Occurrence Handle1:STN:280:DC%2BD383ntFKgtw%3D%3D Occurrence Handle10.1136/gut.50.6.881
S Ueno G Tanabe K Sako T Hiwaki H Hokotate Y Fukukura et al. (2001) ArticleTitleDiscrimination value of the new western prognostic system (CLIP score) for hepatocellular carcinoma in 662 Japanese patients. Cancer of the Liver Italian Program Hepatology 34 529–34 Occurrence Handle11526539 Occurrence Handle1:STN:280:DC%2BD3Mvot1yksg%3D%3D Occurrence Handle10.1053/jhep.2001.27219
JA Marrero GL Su W Wei D Emick HS Conjeevaram RJ Fontana et al. (2003) ArticleTitleDes-gamma carboxyprothrombin can differentiate hepatocellular carcinoma from nonmalignant chronic liver disease in American patients Hepatology 37 1114–21 Occurrence Handle12717392 Occurrence Handle1:CAS:528:DC%2BD3sXktVWnsLs%3D Occurrence Handle10.1053/jhep.2003.50195
F Yamashita M Tanaka S Satomura K Tanikawa (1996) ArticleTitlePrognostic significance of Lens culinaris agglutinin A-reactive alpha-fetoprotein in small hepatocellular carcinomas Gastroenterology 111 996–1001 Occurrence Handle8831594 Occurrence Handle1:STN:280:BymH38fkvFU%3D Occurrence Handle10.1016/S0016-5085(96)70067-7
Author information
Authors and Affiliations
Consortia
Rights and permissions
About this article
Cite this article
Ikai, I., Takayasu, K., Omata, M. et al. A modified Japan Integrated Stage score for prognostic assessment in patients with hepatocellular carcinoma. J Gastroenterol 41, 884–892 (2006). https://doi.org/10.1007/s00535-006-1878-y
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00535-006-1878-y