Supplementary Material For: Simple Scoring System for Esophagogastric Varices Prediction in Hepatocellular Carcinoma Patients Without Liver Stiffness Evaluation

Background/Aim: For predicting esophagogastric varices (EGV), the Virtual Baveno VII Consensus Workshop has proposed a combination of liver stiffness determination and platelet count measurement using a FibroScan®. However, that is not available at all institutions. The present study aimed to develop a simple method to predict development of EGV using only general blood examination results. Materials/methods: A total of 1090 hepatocellular carcinoma (HCC) patients were enrolled, after excluding 956 with major portal vein tumor thrombus (Vp3/Vp4) or without upper gastrointestinal endoscopy examination results available. Those with EGV (≥grade F2) or a history of treatment for the condition were defined as positive for significant EGV, then clinical factors were retrospectively evaluated to determine indicators of occurrence. Results: Logistic multivariate analysis showed platelet count (≤12 x104/μL) [odds ratio (OR) 3.79, P<0.001], mALBI grade 2a (OR 1.52, P=0.036), and mALBI 2b or 3 (OR 3.46, P<0.001) as significant predictive factors. Based on the OR values, platelet count (≤12 x104/μL) and mALBI grade 2b/3 were each assigned 2 points and mALBI 2a was given 1 point, with the result termed Recommendation for EGV Screening (REGS) score. EGV occurrence was noted in 2.9% (9/311) of the patients with a REGS score 0, 11.0% (13/118) with a score 1, 19.3% (53/274) with a score 2, 29.5% (39/132) with a score 3, and 38.0% (97/255) with a score 4 (P<0.001). Conclusion: The findings indicate that REGS score can provide useful predictive information for development of significant EGV without the need for special equipment such as a FibroScan®.