Clinical calculator summary
Original 1998 Cancer of the Liver Italian Program score
Clinical calculator summary
Original 1998 Cancer of the Liver Italian Program score
A six-point baseline prognostic score combining cirrhosis severity and HCC tumor features.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original CLIP score and matched historical cohort outcome row without inventing risk groups.
- Population:
- Adults with cirrhosis and established HCC in the original baseline cohort.
- Factors:
- Child-Pugh class, Tumor morphology and liver extension, Raw AFP, Portal vein thrombosis
- Reference:
- Cancer of the Liver Italian Program investigators. Hepatology. 1998;28(3):751-755.
CLIP Score
Clinical Context & Background
Original 1998 CLIP = Child-Pugh (A 0, B 1, C 2) + morphology (uninodular and <=50% 0, multinodular and <=50% 1, massive OR liver extension >50% 2) + AFP (<400 ng/mL 0, >=400 ng/mL 1) + portal vein thrombosis (absent 0, present 1).Reference Data
| CLIP score | Historical median survival in original cohort |
|---|---|
| 0 | Approximately 42.5 months |
| 1 | Approximately 32 months |
| 2 | Approximately 16.5 months |
| 3 | Approximately 4.5 months |
| 4 | Approximately 2.5 months |
| 5-6 | Approximately 1 month |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use at baseline in adults with cirrhosis and established HCC resembling the original cohort.
- Use raw AFP and clinically interpreted imaging morphology, liver extension, and portal vein thrombosis.
How To Interpret
- The total ranges from 0 to 6; the original model did not define low, intermediate, or high risk groups.
- AFP exactly 400 scores one point; exactly 50% liver extension remains in the <=50% category; massive morphology scores two points regardless of extension.
What To Do Next
- Integrate the result with contemporary HCC staging, liver function, imaging, treatment context, patient goals, and multidisciplinary specialist assessment.
- Do not use CLIP alone to determine treatment or transplant eligibility.
Limitations
- Not validated for screening, diagnosis, recurrence detection, post-treatment reassessment, or transplant eligibility.
- Non-cirrhotic HCC is outside the original derivation population.
- Historical cohort outcomes are not individualized survival predictions.
- Morphology, liver extension, and portal vein thrombosis require appropriate imaging interpretation.
Validated Population
Adults with cirrhosis and established HCC assessed at baseline in the original Italian cohort.
Equality example
Child-Pugh A, uninodular disease involving exactly 50% of the liver, AFP 400 ng/mL, and absent PVT gives a CLIP score of 1.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls at CLIP scores 0, exact AFP threshold score 1, and maximum score 6.
- All expected score labels rendered normally.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/clip-hepatocellular-carcinoma-prognosis-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during the route loads and interactions used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/clip-hepatocellular-carcinoma-prognosis.json.
: Browser input adapter corrected and reverified
- Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
- No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
: Full validation test
- 460/460 independent source-rule, exact-boundary, malformed-input, trace, wording, UI, immutability, report, and non-inheritance checks passed.
- No registered panel calculates CLIP; the liver panel remains In review and receives no inherited CLIP verification.
: Calculation and input-contract correction
- Corrected morphology to massive OR liver extension >50%, made AFP exactly 400 score one point, and restored the original historical median-survival rows.
- Replaced pre-scored defaults with four required clinical inputs and strict rejection of missing, extra, coercive, nonfinite, negative, and unsupported values; added a complete four-predictor trace and cautious baseline cirrhotic-HCC scope.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Does AFP exactly 400 ng/mL score a point?
Yes. The original CLIP threshold is AFP greater than or equal to 400 ng/mL.
How is exactly 50% liver extension classified?
Exactly 50% remains in the 50% or less category. Extension above 50%, or massive morphology regardless of extension, scores two morphology points.
Does CLIP determine treatment or transplant eligibility?
No. CLIP is a historical baseline prognostic score and is not a stand-alone treatment or transplant-eligibility rule.
Evidence-based oncology decision support. Verify with clinical guidelines.