Cancer of the Liver Italian Program (CLIP) Score
The Cancer of the Liver Italian Program (CLIP) score is a prognostic tool used to assess the severity and prognosis of liver cancer. It is commonly used in clinical practice to help guide treatment decisions. The CLIP score takes into account several factors including the size and number of tumors, the presence of vascular invasion, and the level of alpha-fetoprotein (AFP) in the blood. By assigning points based on these factors, the CLIP score provides a numerical value that correlates with the likelihood of survival and helps physicians determine the most appropriate treatment approach for each individual patient. The higher the CLIP score, the higher the risk of poor outcomes and the more aggressive the treatment options maybe considered.¹
The CLIP score helps in stratifying patients into different prognostic groups, which in turn guides treatment decisions. It provides valuable information to physicians about the patient’s overall liver function, tumor burden, and vascular invasion, which are important factors in determining the appropriate treatment strategy. ¹
Parameters | Points |
---|---|
Child-Pugh Score A B C | 0 Point 1 Point 2 Points |
Tumor morphology uninodular and extension ≤ 50% multinodular and extension ≤ 50% massive or extension > 50% | 0 Point 1 Point 2 Points |
AFP at baseline < 400 ng/ml ≥ 400 ng/mL | 0 Point 1 Point |
Portal vein thrombosis No Yes | 0 Point 1 Point |
Total CLIP score ranges from 0-6, with median survival by CLIP score as follows: | 0 = 42.5 months 1 = 32.0 months 2 = 16.5 months 3 = 4.5 months 4 = 2.5 months 5-6 = 1 month |
- Kudo M, Chung H, Osaki Y. Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score). Journal of gastroenterology. 2003 Mar;38:207-15.
- Karademir S. Staging of hepatocellular carcinoma. Hepatoma Res. 2018;4:58.
- Kinoshita, Akiyoshi et al. “Staging systems for hepatocellular carcinoma: Current status and future perspectives.” World journal of hepatology vol. 7,3 (2015): 406-24. doi:10.4254/wjh.v7.i3.406