Prospective validation of the CLIP score: A new prognostic system for patients with cirrhosis and hepatocellular carcinoma

Citation
F. Perrone et al., Prospective validation of the CLIP score: A new prognostic system for patients with cirrhosis and hepatocellular carcinoma, HEPATOLOGY, 31(4), 2000, pp. 840-845
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
HEPATOLOGY
ISSN journal
0270-9139 → ACNP
Volume
31
Issue
4
Year of publication
2000
Pages
840 - 845
Database
ISI
SICI code
0270-9139(200004)31:4<840:PVOTCS>2.0.ZU;2-3
Abstract
Prognosis of patients with cirrhosis and hepatocellular carcinoma (HCC) dep ends on both residual liver function and tumor extension. The CLIP score in cludes Child-Pugh stage, tumor morphology and extension, serum alfa-fetopro tein (AFP) levels, and portal vein thrombosis. We externally validated the CLIP score and compared its discriminatory ability and predictive power wit h that of the Okuda staging system in 196 patients with cirrhosis and HCC p rospectively enrolled in a randomized trial. No significant associations we re found between the CLIP score and the age, sex, and pattern of viral infe ction. There was a strong correlation between the CLIP score and the Okuda stage, As of June 1999, 150 patients (76.5%) had died. Median survival time was 11 months, overall, and it was 36, 22, 9, 7, and 3 months for CLIP cat egories 0, 1, 2, 3, and 4 to 6, respectively. In multivariate analysis, the CLIP score had additional explanatory power above that of the Okuda stage. This was true for both patients treated with locoregional therapy or not. A quantitative estimation of 2-year survival predictive power showed that t he CLIP score explained 37% of survival variability, compared with 21% expl ained by Okuda stage. In conclusion, the CLIP score, compared with the Okud a staging system, gives more accurate prognostic information, is statistica lly more efficient, and has a greater survival predictive power. It could b e useful in treatment planning by improving baseline prognostic evaluation of patients with RCC, and could be used in prospective therapeutic trials a s a stratification variable, reducing the variability of results owing to p atient selection.