Reuters Health Information (2005-02-23): New scoring system points to liver cancer outcome
New scoring system points to liver cancer outcome
Last Updated: 2005-02-23 14:41:12 -0400 (Reuters Health)
NEW YORK (Reuters Health) - The Tokyo score, a novel
prognostic system, accurately predicts outcome in Japanese patients
with hepatocellular carcinoma (HCC), according to a report in the March
issue of Gut.
Dr. R. Tateishi and colleagues from University of Tokyo developed
the score, which ranges from 0 to 6 and involves serum albumin,
bilirubin, and size and number of tumors.
The investigators tested its validity in 403 consecutive patients
with HCC treated by percutaneous ablation and in 203 patients who
Five-year survival rates fell significantly with increases in Tokyo
score, the authors report. They declined from 78.7% for patients with
Tokyo scores of 0, to 14.3% for patients with Tokyo scores between 4
In Cox proportional hazard regression models, the Tokyo score proved
equal to the Cancer of the Liver Italian Program (CLIP) scoring system
for HCC, and better than Barcelona Clinic Liver Cancer (BCLC) staging.
Overall, the researchers note, the Tokyo score appeared to be more
informative than the other two systems.
"We established the Tokyo score by analyzing survival time among HCC
patients treated with medical ablation and validated it in patients who
underwent surgical resection," the authors conclude. "The Tokyo score
may be useful in predicting the prognosis of HCC patients who are
candidates for these curative treatments."
In an accompanying editorial, Dr. S. Ryder from Queen's Medical
Centre, Nottingham, UK notes that "it should be emphasized that these
are not natural history based models; almost all patients had therapy
and some patients had more than one treatment modality."
Thus he points out that the outcome "is subject to the impact of
many treatment related effects on survival which may not be
reproducible in standard clinical practice."