title: Chemoembolization of extrahepatic collateral arteries for treatment of hepatocellular carcinoma in the caudate lobe of the liver.
abstract: OBJECTIVE
  This study was designed to evaluate the efficacy and safety in performing chemoembolization of extrahepatic collateral arteries (EHC) for hepatocellular carcinoma (HCC) located in the caudate lobe.
  
  
  METHODS
  Between January 2006 and November 2013, chemoembolization via EHC was performed in 35 patients with 35 caudate HCCs. Preprocedural and follow-up CT or MR scans, angiographic images, and medical records were reviewed retrospectively in consensus. Chi-square analysis was used to evaluate the relationship between tumor characteristics and type of EHC and that between tumor response and the characteristics of the tumor and chemoembolization.
  
  
  RESULTS
  In 31 (88.6 %) patients, EHCs supplying the caudate HCC originated from the right inferior phrenic artery (RIPA). The remaining four HCCs were supplied by the gastroduodenal artery, dorsal pancreatic artery, and right and left gastric arteries. Superselective catheterization of tumor-feeding vessels from the EHC was achieved in 27 patients (77.1 %). There were no major complications. Individual tumor response supplied by the EHC at follow-up contrast-enhanced CT were as follows: complete response (n = 18), partial response (n = 9), stable disease (n = 3), and progressive disease (n = 3). Non-RIPA EHCs were significantly more common in patients who had previously received chemoembolization via the RIPA (50 %) than those who had not (6.5 %; P = 0.01). There was no significant predictive factor associated with tumor response.
  
  
  CONCLUSIONS
  HCC in the caudate lobe can be supplied by several EHCs. Chemoembolization via these arteries can be performed safely and effectively.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, # 101 Daehak-ro, Chongno-gu, Seoul, 110-744, Korea.
authors.forename: Sungmin
authors.initials: S
authors.lastname: Woo
authors.forename: Hyo-Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Hyun-Seok
authors.initials: HS
authors.lastname: Jung
authors.forename: Saebeom
authors.initials: S
authors.lastname: Hur
authors.forename: Myungsu
authors.initials: M
authors.lastname: Lee
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult