AIM:The survival time of patients with hepatocellularcarcinoma(HCC)after resection is hard to predict.Bothresidual liver function and tumor extension factors should beconsidered.A new scoring system has recently beenproposed by the Cancer of the Liver Italian Program(CLIP).CLIP score was confirmed to be one of the best ways tostage patients with HCC.To our knowledge,however,theliterature concerning the correlation between CLIP score andprognosis for patients with HCC after resection was notpublished.The aim of this study is to evaluate therecurrence and prognostic value of CLIP score for thepatients with HCC after resection.METHODS:A retrospective survey was carried out in 174patients undergoing resection of HCC from January 1986 toJune 1998.Six patients who died in the hospital afteroperation and 11 patients with the recurrence of the diseasewere excluded at 1 month after hepatectomy.By the end ofJune 2001,4 patients were lost and 153 patients with curativeresection have been followed up for at least three years.Among 153 patients,115 developed intrahepatic recurrenceand 10 developed extrahepatic recurrence,whereas the other28 remained free of recurrence.Recurrences were classifiedinto early(<■=3 year)and late(>3 year)recurrence.TheCLIP score included the parameters involved in the Child-Pugh stage(0-2),plus macroscopic tumor morphology(0-2),AFP levels(0-1),and the presence or absence of portalthrombosis(0-1).By contrast,portal vein thrombosis wasdefined as the presence of tumor emboli within vascularchannel analyzed by microscopic examination in this study.Risk factors for recurrence and prognostic factors forsurvival in each group were analyzed by the chi-square test,the Kaplan-Meier estimation and the COX proportionalhazards model respectively.RESULTS:The 1-,3-,5-,7-,and10-year disease-free survivalrates after curative resection of HCC were 57.2 %、28.3 %,23.5 %、18.8 % and 17.8 %,respectively.Median survivaltime was 28,16,10,4,and 5 mo for CLIP score 0,1,2,3,and 4to 5,respectively.Early and late recurrence developed in109 patients and 16 patients respectively.By the chi-squaretest,tumor size,microsatellite,venous invasion,tumortype(uninodular,multinodular,massive),tumor extension(<■=or>50 % of liver parenchyma replaced by tumor), TNM stage,CLIP score,and resection margin were the riskfactors for early recurrence,whereas CLIP score and Child-Pugh stage were significant risk factors for late recurrence.In univariate survival analysis,Child-Pugh stages,resectionmargin,tumor size,microsatellite,venous invasion,tumortype,tumor extension,TNM stages,and CLIP score wereassociated with prognosis.The multivariate analysis by COXproportional hazards model showed that the independentpredictive factors of survival were resection margins andTNM stages.CONCLUSION: CLIP score has displayed a unique superiority in predicting the tumor early and late recurrence and prognosis in the patients with HCC after resection. AIM: The survival time of patients with hepatocellular carcinoma (HCC) after resection is hard to predict. Butothurial liver function and tumor extension factors should be condoned. A new scoring system has recently beenproposed by the Cancer of the Liver Italian Program (CLIP) .CLIP score was confirmed to be one of the best ways tostage patients with HCC.To our knowledge, however, theliterature concerning the correlation between CLIP score andprognosis for patients with HCC after resection was notpublished. The aim of this study is to evaluate therecurrence and prognostic value of CLIP score for the patients with HCC after resection. DETHODS: A retrospective survey was carried out in 174 patients undergoing resection of HCC from January 1986 to June 1998. Six patients who died in the hospital afteroperation and 11 patients with the recurrence of the disease were excluded at 1 month after hepatectomy. By the end of June 2001, 4 patients were lost and 153 patients with curative resection have been followed up for at least three years. Among 153 patients, 115 developed intrahepatic recurrence and 10 developed extrahepatic recurrence, while the other 28 remained free of recurrence. Recurrences were classified in early (<■ = 3 year) and late (> 3 year) recurrence.The CLIP score included the parameters involved in the Child-Pugh stage (0-2), plus macroscopic tumor morphology (0-2), AFP levels (0-1), and the presence or absence of portalthure (0-1) portal vein thrombosis wasdefined as the presence of tumor emboli within vascularchannel analyzed by microscopic examination in this study.Risk factors for recurrence and prognostic factors forsurvival in each group were analyzed by the chi-square test, the Kaplan-Meier estimation and the COX proportionalhazards model respectively .RESULTS: The 1-, 3-, 5-, 7-, and10-year disease-free survival rates after curative resection of HCC were 57.2%, 28.3%, 23.5%, 18.8% and 17.8% respectively. 28, 16, 10, 4, and 5 mo for CLIP score 0, 1, 2, 3, and4to 5, respectively. Early and late recurrence developed in 109 patients and 16 patients respectively. By the chi-square test, tumor size, microsatellite, venous invasion, tumortype (uninodular, multinodular, massive), tumor extension (<■ = or> 50% of liver parenchyma replaced by tumor, TNM stage, CLIP score, and resection margin were the risk factors for early recurrence, while CLIP score and Child-Pugh stage were significant risk factors for late recurrence. In univariate survival analysis, Child-Pugh stages, resectionmargin, tumor size, microsatellite, venous invasion, tumortype, tumor extension, TNM stages, and CLIP score wereassociated with prognosis. COOproportional hazards showed by theXXPortal hazards were showed that the independentpredictive factors of survival were resection margins and TNM stages.CONCLUSION: CLIP score has displayed a unique superiority in predicting the tumor early and late recurrence and prognosis in the patients with HCC after resection.