Modified CLIP with objective liver reserve assessment retains prognosis prediction for patients with advanced hepatocellular carcinoma
Resource
J. Gastroenterol. Hepatol., 31(7), 1336-1341
Journal
J. Gastroenterol. Hepatol.
Journal Volume
31
Journal Issue
7
Pages
1336-1341
Date Issued
2016
Date
2016
Author(s)
Abstract
Background and AimThe Cancer of the Liver Italian Program (CLIP) score is a commonly used staging system for hepatocellular carcinoma (HCC) helpful with predicting prognosis of advanced HCC. CLIP uses the Child-Turcotte-Pugh (CTP) score to evaluate liver reserve. A new scoring system, the albumin-bilirubin (ALBI) grade, has been proposed as they objectively evaluate liver reserve. We examined whether the modification of CLIP with ALBI retained its prognosis prediction for patients with advanced HCC. ;MethodsWe included patients who received first-line antiangiogenic therapy for advanced HCC. Liver reserve was assessed using CTP and ALBI scores, which were then incorporated into CLIP and ALBI-CLIP, respectively. To assess their efficacies of prognostic prediction, the Cox's proportional hazard model and concordance indexes were used. ;ResultsA total of 142 patients were included; 137 of them were classified CTP A and 5 patients CTP B. Patients could be divided into four or five groups with different prognosis according to CLIP and ALBI-CLIP, respectively. Higher R-2 (0.249 vs 0.216) and lower Akaike information criterion (995.0 vs 1001.1) were observed for ALBI-CLIP than for CLIP in the Cox's model predicting overall survival. ALBI-CLIP remained an independent predictor for overall survival when CLIP and ALBI-CLIP were simultaneously incorporated in Cox's models allowing variable selection with adjustment for hepatitis etiology, treatment, and performance status. The concordance index was also higher for ALBI-CLIP than for CLIP (0.724 vs 0.703). ;ConclusionsModification of CLIP scoring with ALBI, which objectively assesses liver reserve, retains and might have improved prognosis prediction for advanced HCC.
Subjects
ALBI
Child-Turcotte-Pugh
CLIP
hepatocellular carcinoma
prognosis
SDGs
Other Subjects
bevacizumab; bilirubin; capecitabine; fetoprotein; hepatitis B surface antigen; sorafenib; tegafur; thalidomide; uracil; bilirubin; serum albumin; tumor marker; adult; advanced cancer; aged; albumin bilirubin grade; antiangiogenic therapy; Article; cancer prognosis; diagnostic accuracy; differential diagnosis; drug efficacy; female; human; liver cell carcinoma; liver reserve; major clinical study; male; Modified Cancer of the Liver Italian Program Score; oncological parameters; overall survival; priority journal; scoring system; blood; cancer staging; conservative treatment; forecasting; liver; liver cell carcinoma; liver function test; liver tumor; middle aged; pathology; pathophysiology; physiology; procedures; prognosis; very elderly; young adult; Adult; Aged; Aged, 80 and over; Bilirubin; Biomarkers, Tumor; Carcinoma, Hepatocellular; Female; Forecasting; Humans; Liver; Liver Function Tests; Liver Neoplasms; Male; Middle Aged; Neoplasm Staging; Organ Sparing Treatments; Prognosis; Serum Albumin; Young Adult