CLIP Score (Cancer of the Liver Italian Program)
Staging hepatocellular carcinoma using Child–Pugh class, tumour morphology, AFP and portal vein thrombosis.
Set the clinical parameters above and press “Calculate” to view the CLIP score and its general prognostic interpretation.
Median survival figures are approximate and cohort-dependent; they should not be applied to individual patients without context.
This tool is intended for educational use by health professionals. It does not replace local guidelines, tumour board discussion, transplant criteria such as Milan/UCSF, or individualised patient assessment. Always confirm staging from imaging reports and use your clinical judgement.
CLIP (Cancer of the Liver Italian Program) score is a prognostic staging system for hepatocellular carcinoma (HCC) designed mainly for patients with cirrhosis and unresectable or advanced disease. It combines tumour burden and liver function into a simple 0–6 score that correlates with overall survival.aasldpubs.onlinelibrary.wiley.com+1
The CLIP score uses four routinely available clinical variables: Child–Pugh class (A–C), macroscopic tumour morphology/extent, serum alpha-fetoprotein (AFP) level (< or ≥ 400 ng/mL), and presence of portal vein thrombosis. Each is assigned 0–2 points (or 0–1 for AFP and portal vein thrombosis), and the total gives the CLIP stage.OAE Publishing+1 Patients with a score of 0 generally have the best prognosis (median survival around 3–4 years in some cohorts), whereas scores ≥4 are associated with a very poor prognosis, often measured in a few months despite treatment.PMC+1
Compared with older systems such as Okuda, CLIP better differentiates outcomes in intermediate and advanced HCC and has been externally validated in multiple Western and Asian cohorts.OAE Publishing+1 However, it is less sensitive for very early, screen-detected HCC (where transplant/resection/ablation decisions are usually guided by BCLC, Milan, or local transplant criteria instead).OAE Publishing CLIP is therefore most useful as a prognostic tool and for stratifying patients in clinical studies, rather than as a stand-alone treatment algorithm.
