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Meta-Analysis
. 2024 Sep;30(Suppl):S186-S198.
doi: 10.3350/cmh.2024.0366. Epub 2024 Aug 21.

Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis

Jung Hwan Yu  1 , Ji Won Han  2   3 , Young Ju Suh  4 , Young Eun Chon  5 , Hee Yeon Kim  6 , Ji Hyun An  7 , Young-Joo Jin  1 , Miyoung Choi  8 , Seung Up Kim  9 , Dae Won Jun  10 , Han Ah Lee  11 , Mi Na Kim  9
Affiliations
Meta-Analysis

Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis

Jung Hwan Yu et al. Clin Mol Hepatol. 2024 Sep.

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).

Conclusion: 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: Hepatocellular carcinoma; Noninvasive test; Transient elastography.

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Conflict of interest statement

Conflicts of Interest

The authors have no conflict of interest to declare.

Figures

Figure 1.
Figure 1.
Flowchart showing the study identification, screening, and inclusion process. Of the 1,969 individual studies identified, 13 studies were finally registered. HCC, hepatocellular carcinoma.
Figure 2.
Figure 2.
Forest plot on the association between VCTE value and HCC recurrence. HCC, hepatocellular carcinoma; VCTE, vibration-controlled transient elastography; CI, confidence interval.
Figure 3.
Figure 3.
Meta-analysis for HCC recurrence after hepatic resection. Results of meta-analysis for negative and positive predictive value of HCC recurrence (A) and SROC curve for diagnostic ability for HCC recurrence (B). HCC, hepatocellular carcinoma; SROC, summary receiver operating characteristic.
Figure 4.
Figure 4.
Forest plot on the association between VCTE value and postoperative complications. VCTE, vibration-controlled transient elastography; CI, confidence interval.
Figure 5.
Figure 5.
Meta-analysis for postoperative complications. Results of meta-analysis for negative and positive predictive value of postoperative complications (A) and SROC curve for diagnostic ability for postoperative complications (B). SROC, summary receiver operating characteristic.
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