Abdominal radiology (New York) · 2025
Imaging surveillance outcomes of hepatocellular adenomas: systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Shen Luyao, Altmayer Stephan, Tse Justin Ruey
Аннотация
OBJECTIVES: Hepatocellular adenomas (HCA) are typically resected if > 5 cm after 6 months due to historical risks of bleeding and malignant transformation. Outcomes of contemporary patients managed with surveillance are not well defined. We performed a systematic review and meta-analysis of patients with HCAs monitored for ≥ 6 months to assess rates of size stability, bleeding, and malignant transformation.
METHODS: PubMed, Web of Science, and Embase databases were searched up to August 2025 for all articles reporting HCA and follow-up. Risk of bias was assessed with modified Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Pooled proportions of outcomes were assessed with linear mixed model and logistic regression. Heterogeneity was assessed with the I2 index.
RESULTS: Of 679 articles screened, 7 retrospective studies (2019-2023) with 699 patients across Europe and United States were included. Five were multicenter. Median follow-up ranged from 2 to 5.8 years. For size stability, four studies used Response Evaluation Criteria in Solid Tumors (RECIST); others used a 1 cm size threshold, regression to < 5 cm, or unspecified criteria. Six studies showed moderate to serious risk of bias. Pooled proportion of HCAs that were stable or regressed was 88.5%. Pooled incidences of symptomatic bleeding and malignant transformation were 0.5% and 0.8%, respectively.
CONCLUSION: In a contemporary series, the majority of untreated HCAs were stable or regressed during surveillance, with extremely low incidences (< 1%) of bleeding and malignant transformation. Extending surveillance intervals may safely offer patients more time to address modifiable risk factors.
METHODS: PubMed, Web of Science, and Embase databases were searched up to August 2025 for all articles reporting HCA and follow-up. Risk of bias was assessed with modified Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Pooled proportions of outcomes were assessed with linear mixed model and logistic regression. Heterogeneity was assessed with the I2 index.
RESULTS: Of 679 articles screened, 7 retrospective studies (2019-2023) with 699 patients across Europe and United States were included. Five were multicenter. Median follow-up ranged from 2 to 5.8 years. For size stability, four studies used Response Evaluation Criteria in Solid Tumors (RECIST); others used a 1 cm size threshold, regression to < 5 cm, or unspecified criteria. Six studies showed moderate to serious risk of bias. Pooled proportion of HCAs that were stable or regressed was 88.5%. Pooled incidences of symptomatic bleeding and malignant transformation were 0.5% and 0.8%, respectively.
CONCLUSION: In a contemporary series, the majority of untreated HCAs were stable or regressed during surveillance, with extremely low incidences (< 1%) of bleeding and malignant transformation. Extending surveillance intervals may safely offer patients more time to address modifiable risk factors.