I-CLIP: improved stratification of advanced hepatocellular carcinoma patients by integrating plasma IGF-1 into CLIP score.

Journal Article (Journal Article)

OBJECTIVE: Improving the prognostic stratification of unresectable hepatocellular carcinoma (HCC) patients is critically needed. Since patients' survival is closely linked to the severity of the underlying liver disease, and insulin-like growth factor-1 (IGF-1) is produced predominantly in the liver, we hypothesized that IGF-1 may correlate with patients' survival and hence improve the prognostic ability of the Cancer of the Liver Italian Program (CLIP) score. METHODS: Baseline plasma IGF-1 and clinicopathologic parameters were available from 288 patients. Multivariate Cox regression models, Kaplan-Meier curves, and the log-rank test were applied. Recursive partitioning was used to determine the optimal cut point for IGF-1 using training/validation samples. Prognostic ability of the I-CLIP (I = IGF) was compared to CLIP using C-index. RESULTS: IGF-1 significantly correlated with the clinicopathologic features. With an optimal IGF-1 cut point of 26 ng/ml, the overall survival of patients with IGF-1 >26 was 17.7 months (95% CI 13.6-22.8), and with IGF-1 ≤26 was 5.8 months (95% CI 4.0-12.5), p < 0.0001. The concordance probabilities for CLIP and I-CLIP were 0.7037 and 0.7096, respectively (p < 0.0001). CONCLUSIONS: Our preliminary results indicate that I-CLIP significantly improved prognostic stratification of patients with advanced HCC. However, independent validation of our study is warranted.

Full Text

Duke Authors

Cited Authors

  • Kaseb, AO; Abbruzzese, JL; Vauthey, J-N; Aloia, TA; Abdalla, EK; Hassan, MM; Lin, E; Xiao, L; El-Deeb, AS; Rashid, A; Morris, JS

Published Date

  • 2011

Published In

Volume / Issue

  • 80 / 5-6

Start / End Page

  • 373 - 381

PubMed ID

  • 21822028

Pubmed Central ID

  • PMC3171278

Electronic International Standard Serial Number (EISSN)

  • 1423-0232

Digital Object Identifier (DOI)

  • 10.1159/000329040


  • eng

Conference Location

  • Switzerland