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The model for end-stage liver disease-based Japan Integrated Scoring system may have a better predictive ability for patients with hepatocellular carcinoma undergoing locoregional therapy
Version of Record online: 17 MAY 2006
Copyright © 2006 American Cancer Society
Volume 107, Issue 1, pages 141–148, 1 July 2006
How to Cite
Huo, T.-I., Lin, H.-C., Huang, Y.-H., Wu, J.-C., Chiang, J.-H., Lee, P.-C. and Lee, S.-D. (2006), The model for end-stage liver disease-based Japan Integrated Scoring system may have a better predictive ability for patients with hepatocellular carcinoma undergoing locoregional therapy. Cancer, 107: 141–148. doi: 10.1002/cncr.21972
- Issue online: 16 JUN 2006
- Version of Record online: 17 MAY 2006
- Manuscript Accepted: 27 MAR 2006
- Manuscript Revised: 18 JAN 2006
- Manuscript Received: 28 NOV 2005
- National Science Council, Executive Yuan, Taiwan. Grant Number: NSC 94-2314-B-010-049
- Cancer of Liver Italian Program;
- hepatocellular carcinoma;
- Japan Integrated Scoring;
- Model for End-Stage Liver Disease
The Japan Integrated Scoring (JIS) system was revealed as a better model for outcome prediction compared with the Cancer of Liver Italian Program system for hepatocellular carcinoma (HCC), and the Model for End-Stage Liver Disease (MELD) was better as a prognostic predictor for patients with cirrhosis compared with the Child–Turcotte–Pugh (CTP) system, which is a parameter used in the JIS system. The objective of the current study was to investigate the performance of the modified MELD-based JIS system.
In the modified JIS system, the CTP class in the original JIS was replaced with MELD cut-off scores of <10, 10 to 14, and >14. The modified JIS system was compared with the original system in 276 patients with HCC who underwent locoregional therapy (transarterial chemoembolization or percutaneous injection).
The mean ± standard error original JIS score was 1.8 ± 1.0 (range, 0-4), compared with 2.0 ± 1.1 (range, 0-5) for the modified JIS system (P<.001). Using mortality as the endpoint, the area under receiver operating characteristic curve (AUC) for the modified JIS system was 0.804 compared with 0.741 for the original JIS system (P = .008) at 12 months, and the AUC was 0.853 and 0.765, respectively (P<.001), at 24 months. Survival analysis showed that the modified JIS system had a better discriminatory ability for patients in different score groups and was more accurate for outcome prediction in the Cox multivariate model.
The current results indicated that the MELD-based, modified JIS system has improved predictive ability compared with the original system and is a more feasible model for clinical staging in patients with HCC who are undergoing locoregional therapy. Cancer 2006. © 2006 American Cancer Society.