| BACKGROUND The life expectancy of a patient with advanced hepatocellular carcinoma (HCC) is hard to predict, making it difficult to decide whether a certain treatment is indicated and what to say to the patient regarding prognosis. The objectives of this study were to construct a new staging scheme for patients with HCC, and to investigate the clinical value of the stage for the selection of treatment and the evaluation of therapeutic effect. METHODS A retrospective analysis of the cases of HCC from 1999 to 2003 was performed. The Cox model was used for multivariate analyses. The final model was derived from 10 randomly chosen training samples and the prognostic validity of the China Integrated Staging score (CIS score) was assessed on the corresponding testing samples. Fifty-four patients with HCC were recruited and prospectively followed up. Staging was performed at the baseline using the CIS score, Okuda, and CLIP score. RESULTS A simple scoring system (CIS score) was produced, assigning linear scores (0/1/2) to the covariates (TNM, α -fetoproein, and Child-Pugh). The CIS score has able to predict survival better than the Okuda or TNM staging system, as by confirmed by the Kaplan-Meier comparison of survival curves and by the Cox regression analysis, with a median survival rate of 9.0,2.3,2.0 and 0.6 months in patients with CIS scores II, III, IV and V. CONCLUSION The new staging system, accounting for both liver function and tumor characteristics, can accurately identify patients with different prognoses, particularly in the advanced phases of HCC, thus representing a useful tool in the treatment of the disease.
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