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Incomplete tumor capsule on preoperative imaging reveals microvascular invasion in hepatocellular carcinoma: a systematic review and meta-analysis.

Purpose: Microvascular invasion (MVI), which is difficult to diagnose before surgery, is a major factor affecting postoperative recurrence in patients with hepatocellular carcinoma (HCC). The relationship between the radiological tumor capsule and MVI is controversial. This study aimed to evaluate t...

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Published in:Abdominal Radiology Vol. 44; no. 9; pp. 3049 - 3058
Main Authors: Zhu, Fei, Yang, Fan, Li, Jing, Chen, Weixia, Yang, Weilin
Format: Journal Article
Published: Springer Nature Sep2019
Online Access:View this record in EBSCOhost
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      jtl: Abdominal Radiology
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      dt: Sep2019
      vid: 44
      iid: 9
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      pub: Springer Nature
      place: New York, New York
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        138030445
        144187704
        10.1007/s00261-019-02126-9
        138030445
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        atl: Incomplete tumor capsule on preoperative imaging reveals microvascular invasion in hepatocellular carcinoma: a systematic review and meta-analysis.
      aug:
        au:
          Zhu, Fei
          Yang, Fan
          Li, Jing
          Chen, Weixia
          Yang, Weilin
        affil: Department of Radiology, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan, China
      sug:
      ab: Purpose: Microvascular invasion (MVI), which is difficult to diagnose before surgery, is a major factor affecting postoperative recurrence in patients with hepatocellular carcinoma (HCC). The relationship between the radiological tumor capsule and MVI is controversial. This study aimed to evaluate the association between the tumor capsule and MVI. Methods: We searched Medline (by PubMed) and Embase (by OvidSP). Two review authors independently screened titles and abstracts, selected studies about MVI prediction with radiologic tumor capsule and studies with enough data for extracted, assessed the methodological quality and collected data. Summary results were presented as the diagnostic odds ratio (DOR), sensitivity, specificity, and 95% confidence interval. Results: Fifteen studies with 2038 patients were included; fourteen studies, including 1331 patients, with no significant heterogeneity indicated no relationship between absent tumor capsule and MVI [DOR = 0.90 (0.64, 1.26)]. Six studies, including 541 patients, with no significant heterogeneity showed incomplete capsule could be used to predict MVI of HCC preoperatively [DOR = 1.85 (1.13, 3.04)]. The overall sensitivity and specificity estimate were 0.50 (0.37, 0.64) and 0.64 (0.53, 0.74), respectively. Eight studies, including 1349 patients, with highly significant heterogeneity revealed that complete capsule could be a protective factor for MVI [DOR = 1.97 (1.01, 3.86)]. Conclusions: For MVI of HCC, incomplete tumor capsule is a risk factor, while a complete tumor capsule might be a protective factor. However, absent capsule doesn't show significant relationship with MVI. This might be due to combination of the risk and protective effects of present capsule in MVI.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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