| Evaluation of Predictive Value of Okuda, TNM, CLIP and JIS Staging Systems for Hepatocellular Carcinoma Patients |
| Sung-Wook Lee, M.D., Sang-Young Han, M.D., Kyoung-Tae Kim, M.D.,
Yang-Hyun Baek, M.D., In Young Koh, M.D., Byoung-Hee Kim, M.D., Eun-Hee Park, M.D.,
Jin-Seok Jang, M.D., Myung-Hwan Roh, M.D, Jong Cheol Choi, M.D. |
| Department of Internal Medicine and Diagnostic Radiology1, Dong-A University College of Medicine, Busan, Korea |
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| ABSTRACT |
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Background/Aims
The aims of this study were to validate the prognostic value of the JIS score for HCC
and to compare discriminatory ability and predictive power with other staging systems such as Okuda, TNM
and CLIP. Methods: We analyzed the clinical records of 210 patients who were diagnosed as HCC from 2000
to 2002. Univariate and multivariate survival analyses were done to find out factors to affect survival. To
validate prognostic value of those staging systems, survival curve was obtained and analyzed by the
Kaplan-Meier’s method, and to compare discriminatory ability and predictive power, Homogeneity LR X2 test
and AIC score were used. Results: The median survival was 19.5 months (19.1±14.9). The number of patients
and 3-year survival rate for those staging systems were Okuda 1(126, 57.7%), 2(63, 9.0%) and 3(21, 0.0%)
(p<0.001); TNM I (34, 63.1%), II (71, 59.4%), III (50, 22.4%), IV-A (6, 14.3%) and IV-B (1, 6.5%) (p<0.001);
CLIP 0 (79, 68.5%), 1 (39, 34.2%), 2 (36, 16.7%), 3 (25, 20.0%), 4 (18, 5.1%), 5 (9, 11.1%) and 6 (4, 0.0%)
(p<0.001) and JIS 0 (26, 78.9%), 1 (65, 65.3%), 2 (43, 21.9%), 3 (40, 25, 8.0%) and 5 (11, 2.0%)(p<0.001) in
univariate analysis using Kaplan-Meier analysis. Homogeneity LR X2 test showed more stratification power in
JIS (Okuda, 102.8; TNM, 128.2; CLIP, 148.4 and JIS, 185.6) and AIC score showed superior predictive power
in JIS system (Okuda, 1228.5; TNM, 1130.3; CLIP, 1117.1 and JIS, 1093.6). Conclusions: The proposed JIS
system is useful system to predict survival of HCC patients. The discriminate ability of the JIS score is much
better than other staging systems and has better prognostic predictive power compared to other staging
systems. (Korean J Hepatol 2007;13:196-207) |
| KeyWords:
Carcinoma, hepatocellular; Neoplasm staging; Outcome assessment, patient; Prognosis; Survival analysis |
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