Role of vessels encapsulating tumor clusters patterns in hepatocellular carcinoma: a literature review

Hepatocellular carcinoma (HCC) is one of the most common and highly lethal tumors worldwide. Early metastasis is the main cause of postoperative recurrence and high mortality in patients with HCC. Vessels encapsulating tumor clusters (VETCs) are a distinct vascular metastatic pattern different from microvascular invasion, which has higher recurrence and mortality rates because of its unique metastatic mechanism; however, VETC is currently recognized only by the morphological manifestations of pathology, while in-depth understanding and discussion are insufficient. In future clinical practice, VETC patterns may have a nonnegligible role in the prediction of HCC, therapeutic decision-making, and are closely related to the long-term survival and management of patients. In addition, there is unlimited research potential regarding the mechanism of VETC patterns. This paper summarizes VETC-positive HCC based on pathogenesis, diagnosis, prognosis, and treatment, and discusses current limitations and future prospects.