Prognostic assessment of five scoring systems for survival rate of advanced hepatocellular carcinoma

Abstract

Objective To evaluated the value of five current prognostic scoring systems, i.e. CLIP(Cancer of the Liver Italian Program), TNM, JIS(Japanese integrated score), TOKYO, MELD(model for end-stage liver disease) in predicting the 3-month mortality, 6-month mortality and overall survival for advanced liver cancer patients. Methods Data of 253 patients were collected. They were classified according to CLIP, TNM, JIS, TOKYO and MELD scoring systems respectively at their first diagnosis and were followed up afterwards. Relative operating characteristic (ROC) curve analysis and The Delong. et al test was used to compare A (Area under curve) of ROC curve, in order to evaluate the sensitivity and specificity of 3-month mortality and 6-month mortality predicting value of different scoring systems. Kaplan-Meier survival curve and log-rank test were used to compare the advanced HCC's overall survival rate of different scoring systems, and likelihood ratio test (LRT) was used to evaluate different scoring systems' predicting value of advanced HCC's overall survival. Results For 3-month mortality, the prognostic values in predicting 3-month mortality of CLIP, JIS and Tokyo were similar. A of CLIP was significantly higher than that of MELD, TNM in predicting 3-month mortality (P < 0.05) . For 6-month mortality, the prognostic values in predicting 6-month mortality of CLIP, JIS and Tokyo were similar. A of CLIP was significantly higher than that of JIS, TOKYO, MELD, TNM in predicting 6-month mortality (P < 0.05) .χ2 of CLIP was the highest and CLIP scoring system's predicting value of overall survival is best. Conclusion CLIP is the best scoring system in predicting 3-month mortality, 6-month mortality and overall survival of advanced HCC. Key words: Advanced hepatocellular carcinoma; 3-month mortality; 6-month mortality; CLIP (Cancer of the Liver Italian Program)