GRETCH system
The GRETCH system, proposed in 1999 by the French Goupe d’Etude, is derived from a cohort of 761 HCC patients treated at Western medical centers. It employs five prognostic factors (Karnofsky index, serum bilirubin, ALP, serum AFP, and ultrasonographic portal obstruction) for risk classification (A: low risk, B: intermediate risk, C: high risk). Survival rates vary significantly among groups. The system’s strength lies in using readily available baseline characteristics and scores based on estimated Cox regression coefficients.
| Variables | 0 | 1 | 2 | 3 |
|---|---|---|---|---|
| Karnofsky index (%) | ≥ 80 | < 80 | ||
| Serum bilirubin (μmol/L) | < 50 | ≥ 50 | ||
| Serum ALP (Upper Normal Limit) | < 2 | ≥ 2 | ||
| Serum AFP (μg/L) | < 35 | ≥ 35 | ||
| Portal obstruction (Ultrasound) | Absent | Present |
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