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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.

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Author information

Author notes

  1. Iwao Ikai

    Present address: The Liver Cancer Study Group of Japan, 403 Bear House, 40 Sanno-cho, Shogoin, Sakyo-ku, Kyoto, 606-8392, Japan

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Iwao Ikai & Yoshio Yamaoka

  2. Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan

    Kenichi Takayasu

  3. Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Masao Omata

  4. Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, Ube, Japan

    Kiwamu Okita

  5. Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

    Yasuni Nakanuma

  6. Department of Biostatistics, School of Health Sciences and Nursing University of Tokyo, Tokyo, Japan

    Yutaka Matsuyama

  7. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Masatoshi Makuuchi

  8. Department of Pathology, Kurume University School of Medicine, Kurume, Japan

    Masamichi Kojiro

  9. Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan

    Takafumi Ichida

  10. Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan

    Shigeki Arii

Authors
  1. Iwao Ikai
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  2. Kenichi Takayasu
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  5. Yasuni Nakanuma
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  8. Masamichi Kojiro
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  9. Takafumi Ichida
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  11. Yoshio Yamaoka
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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

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  • DOI: https://doi.org/10.1007/s00535-006-1878-y

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