There are 2 Tables and 3 Figures in the supplement.
Supplementary Table 1.Youden’s index determining the cut-off value in the primary cohort
Supplementary Table 2. Univariate and multivariate analyses of patient’s prognosis in the validation cohort
Supplementary Figure 1. Flow diagram of patients’ inclusion
Supplementary Figure 2. The Kaplan-Meier survival of patients who underwent hepatectomy for multiple HCCs stratified by different prognostic systems in the primary cohort
Supplementary Figure 3. The Kaplan-Meier survival of patients who underwent hepatectomy for multiple HCCs stratified by different prognostic systems in the validation cohort
Supplementary Table 1. Youden’s index determining the cut-off value of N, D and R in the primary cohort
N / 2-5 / 0.0115 (N=2) / 0.1073 (N=3) / 0.1012 (N=4)
R / 1-16 / 0.2166 (R=5) / 0.2240 (R=6) / 0.2057 (R=7)
D，（cm) / 1.9-18.5 / 0.3216 (D=7) / 0.3370 (D=8) / 0.3133 (D=9)
Abbreviations: N, tumor number; D, total tumor diameter; R, ratio of the largest tumor diameter to the smallest diameter; YI: Youden’s index.
*The largest Youden’s indexes were obtained when the cut-off values were set up at 3 for N (range: from 2 to 5), 6 for R (range: from 1 to 16), and 8 cm for D (range: from 1.9 to 18.5 cm), respectively. These cut-off values were used in the study.
** The Youden’s indexes of the values which were most close to and slightly lower or higher than the cut-off values.
Supplementary Table 2. Univariate and multivariate analyses of tumor recurrence and overall survival after hepatectomy in the validation cohort
Variable / n / Time(months) * / P value as Univariate / P value as
Multivariate** / HR
(95% CI)
Tumor recurrence
NDR system
≤2 / 136 / 9.2±0.9 / < 0.001 / < 0.001 / 2.18
(1.50-3.16)
2 / 41 / 4.3±0.4
Microvascular invasion
yes / 100 / 7.1±0.7 / 0.18 / 0.009 / 1.53
(1.11-2.11)
no / 76 / 10.3±1.0
Intraoperative blood transfusion
yes / 41 / 4.7±1.0 / 0.004 / - / -
no / 136 / 9.2±0.8
Overall survival
NDR system
≤2 / 136 / 48.7±3.3 / < 0.001 / < 0.001 / 3.34
(2.13-5.23)
2 / 41 / 16.8±6.3
Intraoperative blood transfusion
yes / 41 / 43.7±3.4 / 0.002 / - / -
no / 136 / 23.8±6.0
* Results were presented as median ± standard error.
**Results of the uni- and multivariate analyses were shown only for the significant variables.
Supplementary Figure 1. Flow diagram of patients’ inclusion
Supplementary Figure 2. The Kaplan-Meier survival of patients with multiple HCCs who underwent hepatectomy stratified by different prognostic systems in the primary cohort.
A: NDR score system; B: TNM 6th staging system; C: BCLC staging system; D: CLIP staging system; E: JIS staging system
Supplementary Figure 3. The Kaplan-Meier survival of patients with multiple HCCs who underwent hepatectomy stratified by different prognostic systems in the validation cohort.
A: NDR score system; B: TNM6th staging system; C: BCLC staging system; D: CLIP staging system; E: JIS staging system
1