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Prognoses and Clinicopathological Characteristics for Hepatocellular Carcinoma Originating from the Caudate Lobe After Surgery

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Abstract

Background

The aim was to evaluate the prognoses and clinicopathological characteristics of solitary hepatocellular carcinoma (HCC) originating from the caudate lobe (HCC-CL).

Methods

We analyzed 584 patients with a solitary tumor <10 cm from January 1990 to November 2014. Patients were classified into a caudate lobe group (CL; n = 39) and a non-caudate lobe group (NCL; n = 545). We investigated the prognoses and clinicopathological characteristics of solitary HCC-CL. We compared the surgical procedures performed in these cases.

Results

HCC-CL had a similar rate of portal venous invasion (PVI) as HCC-NCL (21% vs. 19%); however, the frequency of tumor thrombus at the first branch of the portal vein (PV) or extension to the trunk or the opposite side of the PV was significantly higher in HCC-CL (8% vs. 2%). HCC-CL had similar OS rates compared to HCC-NCL; however, HCC-CL showed significantly poorer RFS. Although there were no significant differences among the three surgical procedures, blood loss and complication rates tended to be higher in cases who underwent an isolated caudate lobectomy. Tumor size ≥5 cm, PVI, and liver fibrosis or cirrhosis (LF or LC) were independent unfavorable factors for both OS and RFS. PIVKA-II ≥120 mAU/ml was an independent unfavorable factor for RFS.

Conclusion

HCC-CL presented a poorer RFS rate. Patients with a tumor size ≥5 cm, PIVKA-II ≥120 mAU/ml, portal venous invasion, and LF or LC should be diligently followed up as these cases have a high risk of recurrence.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15-West 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan

    Shingo Shimada, Toshiya Kamiyama, Hideki Yokoo, Tatsuya Orimo, Akihisa Nagatsu, Takanori Ohata, Hirofumi Kamachi & Akinobu Taketomi

Authors
  1. Shingo Shimada
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  2. Toshiya Kamiyama
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  3. Hideki Yokoo
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  4. Tatsuya Orimo
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  5. Akihisa Nagatsu
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  6. Takanori Ohata
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  7. Hirofumi Kamachi
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  8. Akinobu Taketomi
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Corresponding author

Correspondence to Toshiya Kamiyama.

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The authors declare that they have no conflict of interest.

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Shimada, S., Kamiyama, T., Yokoo, H. et al. Prognoses and Clinicopathological Characteristics for Hepatocellular Carcinoma Originating from the Caudate Lobe After Surgery. World J Surg 43, 1085–1093 (2019). https://doi.org/10.1007/s00268-018-4869-2

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  • DOI: https://doi.org/10.1007/s00268-018-4869-2

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