| Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis |
Jung Hwan Yu1, Ji Won Han2,3, Young Ju Suh4, Young Eun Chon5, Hee Yeon Kim6, Ji Hyun An7, Young-Joo Jin1, Miyoung Choi8, Seung Up Kim9, Dae Won Jun10, Han Ah Lee11
, Mi Na Kim9
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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 |
| Correspondence : |
Han Ah Lee ,
Tel: +82-2-6299-1408, Fax: +82-2-6299-2469, Email: amelia86@naver.com
Mi Na Kim ,
Tel: +82-2-2228-1939, Fax: +82-2-393-6884, Email: minakim@yuhs.ac
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Received: May 16, 2024 Revised: August 18, 2024 Accepted: August 19, 2024
*Jung Hwan Yu and Ji Won Han contributed equally to this work. |
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| ABSTRACT |
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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. |
| KeyWords:
Noninvasive test; Transient elastography; Hepatocellular carcinoma |
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