Clin Mol Hepatol.
2024 Sep;30(suppl):s186-s198. 10.3350/cmh.2024.0366.
Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis
- Affiliations
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- 1Department of Internal Medicine, Inha University Hospital and School of Medicine, Incheon, Korea
- 2The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 3Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- 4Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, Korea
- 5Department of Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
- 6Department of Internal Medicine, College of Medicine, Bucheon St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- 7Department of Gastroenterology and Hepatology, Hanyang University College of Medicine, Guri, Korea
- 8Clinical Evidence Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Korea
- 9Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- 10Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- 11Department of Internal Medicine, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
- KMID: 2559591
- DOI: http://doi.org/10.3350/cmh.2024.0366
Abstract
- Backgrounds/Aims
This meta-analysis examined whether preoperative vibration-controlled transient elastography (VCTE) can predict postoperative complications and recurrence in patients undergoing hepatic resection for hepatocellular carcinoma (HCC).
Methods
A systematic literature search was conducted using Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases. Out of 431 individual studies, thirteen published between 2008 and 2022 were included. Five studies focused on HCC recurrence, while eight examined postoperative complications.
Results
The meta-analysis of five studies on HCC recurrence showed that the high-risk group with a high VCTE score had a significantly increased recurrence rate after hepatic resection (hazard ratio 2.14). The cutoff value of VCTE in the high-risk group of HCC recurrence was 7.4–13.4 kPa, the sensitivity was 0.60 (95% confidence interval [CI] 0.47–0.72), and the specificity was 0.60 (95% CI 0.46–0.72). The area under the receiver operating characteristic curve (AUC) of the liver stiffness measured by VCTE to predict the HCC recurrence was 0.63 (95% CI 0.59–0.67). The meta-analysis on the postoperative complications revealed a significantly increased risk of postoperative complications in the high-risk group (12–25.6 kPa) with a high VCTE value (odds ratio [OR], 8.32). The AUC of the liver stiffness measured by VCTE to predict the postoperative complications was 0.87 (95% CI 0.84–0.90), the sensitivity was 0.76 (95% CI 0.55–0.89) and the specificity was 0.85 (95% CI 0.73–0.92).
Conclusions
This meta-analysis suggests that preoperative VCTE in patients undergoing hepatic resection for HCC is useful in identifying individuals at a high risk of postoperative complications and HCC recurrence.
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