Tournoux et al modified the CLIP score (from the Cancer of the Liver Italian Program) by addition of the WHO/ECOG performance status for evaluating a patient with hepatocellular carcinoma. The authors are from multiple institutions in France.
Patient selection: advanced heptocellular carcinoma with performance status from 0 to 3
Parameters:
(1) Child-Pugh stage
(2) tumor morphology
(3) serum alpha-fetoprotein (AFP) in ng/mL at initial diagnosis
(4) portal vein thrombosis
(5) ECOG performance status
Parameter
Finding
Points
Child-Pugh stage of cirrhosis
A
0
B
1
C
2
tumor morphology
uninodular AND extension <= 50%
0
multinodular AND extension <= 50%
1
massive OR extension > 50%
2
serum AFP
< 400 ng/mL
0
>= 400 ng/mL
1
portal vein thrombosis
absent
0
present
1
performance status
ECOG 0
0
ECOG 1
1
ECOG 2 or 3
2
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score, the worse the survival.
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