title: Caudate lobe hepatocellular carcinoma treated with selective chemoembolization.
abstract: OBJECTIVE
  To analyze the clinical outcomes of chemoembolization for solitary caudate lobe hepatocellular carcinoma (HCC) found at initial presentation.
  
  
  METHODS
  This retrospective study was approved by the institutional review board; the requirement for informed patient consent was waived. From July 1998 to June 2009, 40 patients (28 men, 12 women; mean age, 57 years) found to have a single HCC lesion in the caudate lobe at initial presentation were treated with chemoembolization and evaluated for overall survival and progression-free survival. Multivariate analyses for potential clinical and radiologic factors were performed by using the Cox proportional hazard model.
  
  
  RESULTS
  Selective chemoembolization via the caudate artery was achieved in 34 (85%) patients. Overall survival rates at 1, 2, 3, 4, and 5 years were 92%, 79%, 65%, 56%, and 56%, respectively. Selective chemoembolization of the caudate artery was a critically important factor in longer overall survival (hazard ratio, 0.091; 95% confidence interval [CI]: 0.021, 0.389; P < .001), and portal vein tumor thrombosis (hazard ratio, 31.25; 95% CI: 4.88, 200.1; P < .001) and multiple tumor-feeding vessels (hazard ratio, 6.87; 95% CI: 1.47, 32.1; P = .014) were significant factors in shorter overall survival. Selective chemoembolization of the caudate artery was also a significant factor in longer progression-free survival (hazard ratio, 0.278; 95% CI: 0.10, 0.76; P = .013).
  
  
  CONCLUSIONS
  Selective chemoembolization via the caudate artery is possible in most patients with caudate lobe HCC and a critical factor in longer overall survival and longer progression-free survival.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine; Institute of Radiation Medicine; Seoul National University Medical Research Center, Seoul, Korea.
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Jung-Hwan
authors.initials: JH
authors.lastname: Yoon
authors.forename: Jeong-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Yoon Jun
authors.initials: YJ
authors.lastname: Kim
authors.forename: Hyo-Suk
authors.initials: HS
authors.lastname: Lee
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003287:Contrast Media / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007459:Iodized Oil; D004317:Doxorubicin; C044834:iodixanol