Prognosis of patients undergoing hepatectomy for solitary hepatocellular carcinoma originating in the caudate lobe

Treatment for hepatocellular carcinoma in the caudate lobe: a report of 13 cases

“…13 Factors leading to worse prognosis of surgical treatment of HCC in caudate lobe than in other parts of liver are as follows: complex anatomical structure of caudate lobe, small growth space, invasive growth and easy to invade blood vessels; Insufficient removal of tumor margins due to poorly defined lesion boundary or lesion in the proximity of hepatic portal vein and hepatic vein; difficulty of peeling and exposure of caudate lobe during operation, and excessive turning and pulling of liver lobes increases the possibility of metastasis of HHC through portal vein and hepatic vein; more bleeding in caudate lobe surgery than non-caudate lobe surgery, as studies have shown that intraoperative bleeding and excessive bleeding is the independent risk factor of recurrence and metastasis of hepatocellular carcinoma after operation. [14][15][16] On the other hand, compared with other similar studies, this study showed that the recurrence rate of HCC was higher and the survival rate was lower. [13][14] The possible reasons are as follow: small sample size which led to information bias; all patients included in the study had a history of hepatitis B, and some patient included in similar studies did not suffer from secondary hepatitis B; patients with HCC in caudate lobe had relative large sizes with diameter of 1.8-14 cm, averaging at 5.6 cm, most of which involved other hepatic segments.…”

Surgical outcomes of hepatocellular carcinoma originating from caudate lobe

“…Similarly, Yamamoto et al . and Sakamoto et al . also have reported comparable survival rates for patients with caudate lobe HCC and those with HCC in other locations.…”

“…These papers described 352 patients undergoing caudate resection for HCC. Seven studies were conducted in Japan, three in China, one in Taiwan, one in the USA and one in Egypt . The sample size of each study varied from 6 to 114 patients.…”

“…Compared with HCC originating in other locations, resection of an HCC in the caudate lobe is a surgical challenge that was associated with greater operative times and blood loss . However, this may not be clinically significant and not be translated into an increase in major complications and mortality .…”

Parenchyma-Sparing Liver Surgery for Large Segment 1 Tumors: Ultrasound-Guided Lateral and Superior Approaches as Safe Alternatives to Major Hepatectomy

“…6,9 Small case series of isolated caudate lobectomies have been published with good short-term results. 4,5,[10][11][12][13][14][15] The technical complexity of S1 resection (isolated or not) corresponds to lower oncologic outcomes in comparison with patients undergoing surgery for lesions in other segments. 10 In the presence of large S1 lesions, isolate caudate resections are usually contraindicated because of the technical complexity of the procedure and the risk of an oncologically inadequate procedure.…”