title: Hepatectomy with transcatheter arterial embolization for large hepatoma in the caudate lobe.
abstract: The prognosis of hepatocellular carcinoma originating from the caudate lobe (caudate HCC) is generally poor, and surgical treatment for caudate HCC is difficult to perform due to the location. We postulate that a combination of surgical resection and transcatheter arterial embolization improves the prognosis, and that operative procedure is straightforward. We examined three cases of large solitary caudate HCC. Three patients (a 68-year-old woman, 65-year-old man, and 71-year-old man) with caudate HCC and viral chronic hepatitis were treated with preoperative transcatheter arterial embolization and partial resection of the caudate lobe. After transcatheter arterial embolization, the solitary hepatocellular carcinomas decreased in size (9 to 6, 10 to 8, and 7 to 5 cm in diameter, respectively) which simplified surgical resection (1120, 3010, and 2110 cc blood loss; 4.5, 7, and 7 hours of operative time, respectively). All the hepatocellular carcinomas were poorly differentiated, and had infiltrated microscopically into the portal vein. The outcome was satisfactory (18, 16, and 10 months after the operation, two cases were alive, and one dead, respectively). The combination of preoperative transcatheter arterial embolization and partial resection for caudate HCC, especially large solitary caudate HCC, works well as a multimodal therapy.
authors.affiliation: Osaka City University Graduated School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. takatsugu@msic.med.osaka-cu.ac.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Masao
authors.initials: M
authors.lastname: Ogawa
authors.forename: Seikan
authors.initials: S
authors.lastname: Hai
authors.forename: Katsu
authors.initials: K
authors.lastname: Sakabe
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D011169:Portal Vein / Q000473:pathology; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed