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J BUON. 2019 Jan-Feb;24(1):150-157.

Comparison of 10 prognostic staging systems in patients with advanced hepatocellular carcinoma.

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Department of Vascular Surgery, Northern Jiangsu People's Hospital, the Clinical Medical School of Yangzhou University, Yangzhou, Jiangsu province, China.



To compare the performance of 10 currently staging systems (TNM, Okuda, GETCH, CLIP, CUPI, JIS, CIS, MELD, mJIS, mCLIP) for predicting survival in advanced hepatocellular carcinoma (HCC) patients.


A total of 133 consecutive advanced HCC patients between January 2014 and December 2014 were enrolled in the study. The Kaplan-Meier method compared by the log-rank test was used to estimate the survival distribution. Ranking of staging systems was done by using the concordance index (c-index) to compare the discriminatory capacity. The area under the curve (AUC) was performed to assess the mortality prediction.


The median survival of all 133 patients was 7.5 months. The survival rates at 6, 12, 18 and 24 months were 56%, 30%, 19% and 15%, respectively. CIS and CUPI systems had better performances in survival distribution. CIS, TNM and CLIP systems were the top three ranking staging systems. CIS had the best mortality prediction at 6, 18 and 24 months and CLIP had the best mortality prediction at 12 months.


The CIS system was the most informative staging system for predicting survival in advanced HCC patients with mainly hepatitis B virus etiology.


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