Macroscopic Characterization of Hepatocellular Carcinoma: An Underexploited Source of Prognostic Factors

Figures & data

Box 1 Eligibility Criteria

Human data (in vitro and in vivo studies were excluded). Original data (reviews, commentaries, editorials, systematic review and meta-analyses were excluded). Studies reporting macroscopic characteristics retrieved from pathological analysis of specimen (surgical resection, transplantation or autopsy). Studies retrieving macroscopic variables only based on imaging were excluded. Analysis of the prognostic value of macroscopic variables on either survival or recurrence. The most recent and complete article was chosen if a study had been published more than once. Available full-text publications in English.

Figure 1 Characteristics of the eligible studies. (A) Types of specimen grossly examined. (B) Boxplot representing the distribution of sample size. (C) Endpoints investigated. (D) Types of macroscopic variables analyzed.

Figure 2 Associations between macroscopic features and recurrence. (A) Forest plot illustrating the association of tumor size with recurrence. *Size was analyzed as a dichotomized variable ªDetailed results not provided. (B) Forest plot illustrating the association of number of nodules with recurrence. ªComparison of 2 vs 1 nodule *Detailed results not provided. (C) Forest plot illustrating the association of macroscopic vascular invasion with recurrence.

Abbreviations: N.S., not significant.

Figure 3 Associations between macroscopic features and overall survival (OS). (A) Forest plot illustrating the association of tumor size with OS. *Size was analyzed as a dichotomized variable. ªDetailed results not provided. (B) Forest plot illustrating the association of number of nodules with OS. ªNoN ≥ 2°NoN ≤ 3 °°NoN > 3 *NoN 1–2 vs 3–4. **Detailed results not provided. (C) Forest plot illustrating the association of macroscopic vascular invasion with OS. °Vascular or bile duct invasion.°°Extent to hepatic vein or inferior vena cava. ªInvasion along portal vein system.*Detailed results not provided. (D) Forest plot illustrating the association of macroscopic bile duct invasion with OS. (E) Forest plot illustrating the association of macroscopic growth pattern with OS. *Association between infiltrative type and OS. °Association between single-nodular with extra-nodular growth and OS (detailed results not provided). (F) Forest plot illustrating the association of resection margin with OS. *Detailed results not provided.

Abbreviations: S, Significant; N.S., not significant.