Advanced Liver Cancer Prognostic System (ALCPS) of Yau at al

Description

Yau et al reported the Advanced Liver Cancer Prognostic System (ALCPS) for evaluating a patient with advanced hepatocellular carcinoma. These can help to identify a patient who may require more aggressive management. The authors are from the University of Hong Kong and Queen Mary Hospital in Hong Kong.

Patient: adult (>- 18 years of age) with advanced hepatocellular carcinoma

Parameters:

(1) ascites

(2) abdominal pain

(3) weight loss

(4) Child-Pugh grade (A, B, C)

(5) alkaline phosphatase IU/L

(6) serum total bilirubin in µmol/L

(7) urea in mmol/L

(8) portal vein thrombosis

(9) tumor size

(10) lung metastases

(11) serum alpha-fetoprotein (AFP) in ng/mL

Parameter	Finding	Points
ascites	no	0
	yes	2
abdominal pain	no	0
	yes	2
weight loss	no	0
	yes	2
Child-Pugh grade	A	0
	B	2
	C	5
alkaline phosphatase	<= 200	0
	> 200 IU/L	3
serum total bilirubin	<= 33	0
	33.01 to 50	1
	> 50 µmol/L	3
urea	<= 8.9	0
	> 8.9	2
portal vein thrombosis	no	0
	yes	3
tumor size	<= 5 cm	0
	> 5 cm	3
	diffuse	4
lung metastases	no	0
	yes	3
AFP	<= 400 ng/mL	0
	> 400 ng/mL	4

where:

• The points for Child-Pugh grade A in the original paper is 5 and for grade C is 0.

total score =

= SUM(points for all 11 parameters)

Interpretation:

• minimum score: 0

• maximum score: 33

• The higher the score the lower the 3-month survival rate.

Total Score	Prognosis	3-Month Survival Rate
<= 2	good	> 81%
3 to 6	good	72 to 80%
7 or 8	good	66 to 69%
9	intermediate	63%
10 to 12	intermediate	39 to 51%
13 or 14	intermediate	42 to 47%
15	intermediate	38%
16	poor	33%
17 to 19	poor	21 to 29%
20 to 22	poor	10 to 17%
>= 23	poor	< 10%

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Advanced Liver Cancer Prognostic System (ALCPS) of Yau at al

Description

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