Hiroshi Urakawa MD, Presenter: Nothing to Disclose

Shinichi Koura MD, Abstract Co-Author: Nothing to Disclose

Hideyuki Higashihara MD, Abstract Co-Author: Nothing to Disclose

Kengo Yoshimitsu MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study is to retrospectively compare the usefulness of Cancer of the Liver Italian Program (CLIP) and Japan Integrated Staging (JIS) systems in predicting the prognosis of hepatocellular carcinoma (HCC) patients who had undergone transcatheter arterial chemoembolization (TACE) as initial therapy in Japanese population.

Between 1995 and 2005, consecutive 728 patients with untreated HCC who underwent TACE were selected for this study. Those who underwent hepatectomy or liver transplantation after TACE were excluded. The survival rate and its prognostic factors were assessed by means of multivariate analysis using Cox proportional hazard model. 728 patients were stratified according to the CLIP or JIS scores, and their survival rates between the scores were compared. Likelihood χ2-test and Akaike information criteria were also applied for these two systems for comparison.

The mean follow-up period for all patients was 1689 days. The one-year, 3-year, 5-year, and 10-year survival rates were 83.1%, 55.1%, 34.7%, 12.8%, respectively. There were 150/ 239/ 198/ 80/ 40/ 19/ 2 patients for CLIP scores 0/ 1/ 2/ 3/ 4/ 5/ 6, respectively. There were statistically significant differences in survival rate between the score groups except for between scores 5 and 6. Similarly, there were 57/ 177/ 266/ 147/ 68/ 13 patients for JIS scores 0/ 1/ 2/ 3/ 4/ 5, respectively. There were statistically significant differences between score groups except for between scores 0 and 1 and also between 4 and 5. Multivariate analyses revealed less severe Child-Pugh classification (p<.001), simple tumor morphology (p<.001), absence of portal vein invasion (p<.001), and lower AFP level (p<.001) as independent indicators for favorable survival rate. All of these independent factors were included in the CLIP scoring system, whereas JIS scoring system lacked AFP level. Furthermore, the likelihood χ2-test value was higher, and the Akaike information criterion value was lower for the CLIP system than for JIS system.

The CLIP score is more suitable than JIS score for predicting prognosis of patients with HCC who would undergo TACE in Japanese population.

To predict the prognosis of patients with HCC treated by TACE as initial therapy, we have shown that CLIP system is superior to JIS system, at least in Japanese population.

Urakawa, H, Koura, S, Higashihara, H, Yoshimitsu, K, Which System Is Better to Predict Prognosis of Patients with Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization as Initial Therapy? Comparison between CLIP and JIS System in Japanese Population.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004303.html