A new scoring system for predicting survival in patients with hepatocellular carcinoma : The integration of the JIS and CLIP scoring systems

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Several integrated scoring systems for hepatocellular carcinoma (HCC) have recently been proposed, but there is still no consensus regarding their validity. The present study developed a new scoring system to obtain a better model for predicting the survival of patients with HCC. Data obtained from 1,070 patients with HCC diagnosed at 31 hospitals affiliated with the Niigata Liver Disease Study Group from January 1993 through December 2003 were retrospectively analyzed. The significant factors, which affected the survival of the patients were analyzed, and the best fitting model for the patients' survival was constructed. Fourteen factors were identified based on a univariate analysis, and those factors were used in a multivariate analysis as the candidate prognostic factors. The first Cox's analysis revealed that the Cancer of the Liver Italian Program (CLIP) score, tumor diameter, metastasis (N factor and/or M factor) based on the Liver Cancer Study Group of Japan (LCSGJ), and Japan Integrated Staging (JIS) score were all significant factors. Since the results suggested that both the CLIP and JIS scores were insufficient for the prediction of survival, the Japan Integrated Triform system (JITs) score was designed by removing tumor morphology and portal vein thrombosis from the CLIP score and by adding T factor and metastasis of the LCSGJ. An evaluation by the Akaike information criteria (AIC) showed the JITs score to be a good-fitting model in the present study population. JITs score may hopefully be useful for physicians in determining the appropriate management options.

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