Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Mar 7, 2010; 16(9): 1123-1128
Published online Mar 7, 2010. doi: 10.3748/wjg.v16.i9.1123
Prognostic factors in the surgical treatment of caudate lobe hepatocellular carcinoma
Peng Liu, Jia-Mei Yang, Wen-Yang Niu, Tong Kan, Feng Xie, Dian-Qi Li, Ye Wang, Yan-Ming Zhou
Peng Liu, Jia-Mei Yang, Wen-Yang Niu, Tong Kan, Feng Xie, Dian-Qi Li, Ye Wang, Yan-Ming Zhou, Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Peng Liu, Department of Hepatobiliary Surgery, Navy General Hospital, Beijing 100037, China
Author contributions: Liu P performed liver resection treatments, collected and analyzed the data, and wrote the manuscript; Yang JM performed liver resection treatments, designed the study, collected and analyzed the data, and was involved in editing the manuscript; Niu WY, Kan T, Xie F, Li DQ, Wang Y and Zhou YM participated in the data collection and coordination of the work.
Correspondence to: Jia-Mei Yang, MD, Chief, Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China. jmyang@smmu.edu.cn
Telephone: +86-21-25070808 Fax: +86-21-65562400
Received: August 9, 2009
Revised: December 21, 2009
Accepted: December 28, 2009
Published online: March 7, 2010
Abstract

AIM: To evaluate the short- and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).

METHODS: We retrospectively analyzed 114 consecutive patients with HCC, originating from the caudate lobe, who underwent resection between January 2001 and January 2007. Univariate and multivariate analyses were performed on several clinicopathologic variables to determine the factors affecting long-term outcome and intrahepatic recurrence.

RESULTS: Overall mortality and morbidity were 0% and 18%, respectively. After a median follow-up of 31 mo (interquartile range, 11-66 mo), tumor recurrence had occurred in 76 patients (66.7%). The 1-, 3-, and 5-year disease-free survival rates were 65.7%, 38.1%, and 18.4%, respectively. The 1-, 3-, and 5-year overall survival rates were 76.1%, 54.7%, and 31.8%, respectively. Univariate analysis showed that subsegmental location of the tumor (45.7% vs 16.2%, P = 0.01), liver cirrhosis (12.3% vs 47.9%, P = 0.03), surgical margin (18.5% vs 54.6%, P = 0.04), vascular invasion (37.9% vs 23.2%, P = 0.04) and extended caudate resection (42.1% vs 15.4%, P = 0.04) were related to poorer long-term survival. Multivariate analysis showed that only subsegmental location of the tumor, liver cirrhosis and surgical margin were significant independent prognostic factors.

CONCLUSION: Hepatectomy was an effective treatment for HCC in the caudate lobe. The subsegmental location of the tumor, liver cirrhosis and surgical margin affected long-term survival.

Keywords: Hepatectomy; Hepatocellular carcinoma; Caudate lobe; Prognostic factors