title: Surgery for hepatocellular carcinoma located in the caudate lobe.
abstract: BACKGROUND
  Surgery remains difficult for hepatocellular carcinoma (HCC) originating in the caudate lobe. Our objective was to evaluate the safety and problems associated with caudate lobectomy combined with other types of hepatectomy.
  
  
  METHODS
  We performed caudate resection for HCC in 12 patients. Clinical and operative characteristics and survival were analyzed.
  
  
  RESULTS
  Tumors were located in the Spiegel lobe in three patients, the caudate process in six, and the paracaval portion in three. The procedure performed most was isolated partial caudate lobe resection (six patients). Three patients underwent partial caudate lobe resection combined with other hepatectomy, and the remainder underwent total caudate lobe resection combined with other hepatectomy. Tumors of the patients who underwent combined total caudate lobe resection were mainly in the paracaval portion. The median operating time for the six patients who underwent combined resection was 400 min, and their median intraoperative blood loss was 1,683 ml. There were no postoperative complications in patients who underwent combined total caudate lobe resection, except one case of total resection combined with central bisegmentectomy. In that case, the remaining right posterior sector was twisted after liver extraction, causing blockage of the outflow of the right hepatic vein. The overall and recurrence-free survival rates did not differ between the isolated and combined resection groups.
  
  
  CONCLUSIONS
  For removal of HCC located in the caudate lobe, especially the paracaval portion, partial or total caudate lobe resection with other types of hepatectomy contributes to safe, curative surgery if the liver functional reserve and complications associated with surgery are well understood.
authors: Department of Surgical Oncology and Digestive Surgery, Kagoshima University School of Medicine and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors: Masahiko
authors: M
authors: Sakoda
authors: Shinichi
authors: S
authors: Ueno
authors: Fumitake
authors: F
authors: Kubo
authors: Kiyokazu
authors: K
authors: Hiwatashi
authors: Taro
authors: T
authors: Tateno
authors: Hiroshi
authors: H
authors: Kurahara
authors: Yuukou
authors: Y
authors: Mataki
authors: Hiroyuki
authors: H
authors: Shinchi
authors: Shoji
authors: S
authors: Natsugoe
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome