Hepatocellular carcinoma in the caudate lobe of the liver: angiographic analysis of tumor-feeding arteries according to subsegmental location.
OBJECTIVE
To investigate the tumor-feeding arteries in hepatocellular carcinoma (HCC) arising in the caudate lobe of the liver.


METHODS
From January 1998 to March 2004, 140 patients with 146 caudate HCCs underwent chemoembolization. Subsegmental location of the caudate HCC and the origin of the tumor-feeding arteries was determined with computed tomography and hepatic arteriography. On follow-up angiography at 6-96 months (mean, 24 months), changes in the tumor-feeding arteries were recorded.


RESULTS
A total of 175 tumor-feeding arteries were identified. The tumors in the Spiegel lobe (n = 72) were supplied by tumor-feeding arteries derived from the right hepatic artery (RHA; n = 45), left hepatic artery (LHA; n = 30), and proper hepatic artery (PHA) or common hepatic artery (CHA; n = 6; P = .083, right vs left). In tumors in the paracaval portion (n = 42), the tumor-feeding arteries were derived more frequently from the RHA (n = 46) than the LHA (n = 3) or PHA/CHA (n = 2; P < .001). All the feeding arteries (n = 43) of the caudate process tumors (n = 32) were derived from the RHA (P < .001). During the follow-up period, there were replacements of the tumor-feeding arteries in 16 patients with recurrent tumors. An extrahepatic collateral supply for the recurrent tumors developed in 10 patients.


CONCLUSIONS
The distribution of the origin of tumor-feeding arteries supplying caudate HCC is different according to tumors' subsegmental locations. When treating recurrent caudate HCC, it is important to identify replacement of tumor-feeding arteries and extrahepatic collateral supply.
Yoon
Chang Jin
CJ
Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
Chung
Jin Wook
JW
Cho
Baik Hwan
BH
Jae
Hwan Jun
HJ
Kang
Sung-Gwon
SG
Kim
Hyo-Cheol
HC
Choi
Young Ho
YH
Jeon
Ung Bae
UB
Park
Jae Hyung
JH