ITA.LI.CA tumor Scoring system
The ITA.LI.CA staging system, developed by the Italian Liver Cancer Study Group in 2016, introduces a novel prognostic approach for HCC. It encompasses tumor staging for clinical management and an integrated survival prediction score. With over 5000 Italian HCC patients (mainly HCV) and external validation using a Taiwanese cohort of 2600 patients (mainly HBV), the system offers comprehensive insight. Tumor staging (0, A, B1, B2, B3, C) incorporates largest tumor diameter, nodule count, vascular invasion, and metastases. A multivariable survival model integrates ITA.LI.CA tumor stage, ECOG performance status, Child-Pugh score, and AFP levels to predict individual survival. An integrated prognostic score (0 to 13 points) is derived. The model outperforms existing staging systems (BCLC, CLIP, JIS, MESIAH, HKLC) in discriminative ability.
ITA.LI.CA Tumor Staging
| Diameter of largest nodule (cm) | Number of nodules | Vascular Invasion or Metastasis | Stage |
|---|---|---|---|
| ≤ 2 | 1 | No | 0 |
| ≤ 3 | 2 - 3 | No | A |
| 2 - 5 | 1 | No | A |
| 3 - 5 | 2 - 3 | No | B1 |
| > 5 | 1 | No | B1 |
| > 5 | 2 - 3 | No | B2 |
| ≤ 5 | > 3 | No | B2 |
| > 5 | > 3 | No | B3 |
| Any | Any | Intrahepatic | B3 |
| Any | Any | Extrahepatic | C |