Caudate lobe resection for hepatocellular carcinoma.
OBJECTIVE
Hepatocellular carcinoma (HCC) originating in the caudate lobe is rare, and the treatment for this type of carcinoma is a complex surgical procedure. We aimed to evaluate the surgical outcomes after isolated caudate lobe resection for HCC.


METHODS
We retrospectively analyzed 30 consecutive patients with HCC originating in the caudate lobe who underwent isolated caudate lobe resection.


RESULTS
Thirty patients underwent caudate lobe resection for HCC. The main sites of the tumors were located in the Spiegel lobe, the paracaval portion and caudate process. The surgical margin was tumor negative in all of the patients. The median tumor size was 4.3cm. The mean operative time was 230 ± 50min and the intraoperative blood loss was 1200 ± 200mL. The hospital morbidity rate was 33%. There was no postoperative mortality. The mean survival rate was 25.3+11.7 months. The overall survival rates were 62%, 34% and 11% at 1, 3 and 5 years, respectively. The disease free survival rate after isolated caudate lobectomy was 31% at 3 years. Recurrence was noted in 12 patients (40%). Eleven patients were identified as having intrahepatic recurrences and 1 patient as having peritoneal dissemination.


CONCLUSIONS
Isolated caudate lobe resection is a feasible procedure and can be undertaken with low morbidity and nil mortality. Careful technique and detailed anatomic knowledge of the caudate lobe are essential for this procedure.
Mansoura University, Mansoura, Rgypt. wahab_m_eg@yahoo.com
Mohamed Abdel
MA
Wahab
Omar
O
Fathy
Ehab
E
Elhanafy
Ehab
E
Atif
Ahmad Mohamed
AM
Sultan
Tarek
T
Salah
Mohamed
M
Elshoubary
Nabieh
N
Anwar
Ahmad
A
Sultan
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate