Tzu Chi Medical Journal
Volume 21, Issue 1 , Pages 34-39, March 2009

Comparison Between the CLIP and Okuda Staging Systems for Prediction of Survival Time of Patients with Hepatocellular Carcinoma in Eastern Taiwan

  • Tso-Tsai Liu

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • ,
  • Chi-Shun Yi

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • Research Center of Hepatology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • ,
  • Andy Shau-Bin Chou

      Affiliations

    • Research Center of Hepatology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • Department of Medical Radiology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • ,
  • Ming-Che Lee

      Affiliations

    • Department of General Surgery, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • ,
  • Ming-Cheh Chen

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • Research Center of Hepatology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • ,
  • Li-Yu Wang

      Affiliations

    • Graduate Institute of Aboriginal Health, Buddhist Tzu Chi University, Hualien, Taiwan
    • ,
  • Hans Hsienhong Lin

      Affiliations

    • Research Center of Hepatology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • Division of Gastroenterology, Buddhist Tzu Chi General Hospital Taipei Branch, Taipei, Taiwan
    • ,
  • Chi-Tan Hu

      Affiliations

    • Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • Research Center of Hepatology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Internal Medicine, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, Taiwan

Received 1 August 2007; received in revised form 30 August 2007; accepted 21 March 2008.

Article Outline

Abstract 

Objective

Prediction of the survival time for patients with hepatocellular carcinoma (HCC) by a clinical staging system could influence treatment planning. The aim of this study was to evaluate the predictive power of the Cancer of the Liver Italian Program (CLIP) and the Okuda staging system in the prognosis of patients with HCC in eastern Taiwan.

Materials and Methods

We performed a retrospective chart review of patients admitted from 1986 to 2000 with a diagnosis of HCC. Parameters for staging with the Okuda and CLIP systems were collected. The median survival time and 5-year survival curves were obtained using the Kaplan-Meier method. The discriminatory ability of the systems was also compared.

Results

A total of 342 cases were included in the study. The median survival time of patients at Okuda stage I (24.3% of patients), II (56.1%) and III (19.6%) was 16.8, 5.0 and 1.9 months, respectively. The respective 5-year survival rates were 19.0%, 5% and 0%. The median survival times of patients with CLIP scores of 0 (10.2% of patients), 1 (16.1%), 2 (23.1%), 3 (24.9%), 4 (15.2%), 5 (7.9%) and 6 (2.6%) were 32.7, 10.3, 6.7, 4.7, 2.5, 1.9 and 0.8 months, respectively. The respective 5-year survival rates were 23%, 14%, 10%, 1.1%, 0%, 0% and 0%. The CLIP classification showed more prominent discriminatory ability than the Okuda classification, as confirmed by statistical methods.

Conclusion

The CLIP system is more accurate in identifying patients at both extremes of better and worse prognoses than the Okuda classification, and can be used to stratify patients for prospective therapeutic trials for HCC in eastern Taiwan.

Keywords:  CLIP staging system , Eastern Taiwan , Hepatocellular carcinoma , Okuda staging system , Staging

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PII: S1016-3190(09)60006-9

doi:10.1016/S1016-3190(09)60006-9

Tzu Chi Medical Journal
Volume 21, Issue 1 , Pages 34-39, March 2009

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