Validity of the Algorithm for Liver Resection of Hepatocellular Carcinoma in the Caudate Lobe

• Published in: World journal of surgery Vol. 46; no. 5; pp. 1134 - 1140
• Main Authors: Yoshida, Nao, Midorikawa, Yutaka, Higaki, Tokio, Nakayama, Hisashi, Moriguchi, Masamichi, Aramaki, Osamu, Tsuji, Shingo, Okamura, Yukiyasu, Takayama, Tadatoshi
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.05.2022; John Wiley & Sons, Inc
• Subjects: Abdominal Surgery; Algorithms; Carcinoma, Hepatocellular; Cardiac Surgery; Confidence intervals; General Surgery; Hepatectomy; Hepatocellular carcinoma; Humans; Liver; Liver cancer; Liver Neoplasms; Medicine; Medicine & Public Health; Original Scientific Report; Patients; Retrospective Studies; Surgery; Survival; Thoracic Surgery; Tumors; Vascular Surgery
• ISSN: 0364-2313; 1432-2323; 1432-2323
• DOI: 10.1007/s00268-022-06453-9

Background We aimed to validate our algorithm for resecting Hepatocellular carcinoma (HCC) in the caudate lobe based on tumor location, tumor size, and indocyanine green clearance rate. Methods Patients who underwent curative resections for solitary HCC in the caudate lobe were included. The surgical outcomes of patients with HCC in the caudate lobe were compared with those of patients with HCC in other sites of the liver. Results After one-to-one matching, the caudate-lobe group ( n  = 150) had longer operation time, greater amount of bleeding, lower weight of resected specimens, and shorter distance between tumor and resection line than the other-sites group ( n  = 150), but the complication rates were not different between the groups (38.0% vs. 34.1%, P  = 0.719). After a median follow-up period of 3.0 years (range, 0.3−16.2 years), the median overall survivals were 6.5 (95% confidence interval [CI], 5.3–7.9) and 7.5 years (95% CI, 6.3–9.7) in the caudate-lobe and other-site groups, respectively ( P  = 0.430). Median recurrence-free survivals in the caudate-lobe group (1.9 years; 95% CI, 1.4–2.7) had a tendency to be shorter than those in the other-sites group (2.3 years; 1.7–3.4) ( P  = 0.052). Conclusions Patients’ survival and complication rates in the caudate-lobe group were comparable to those in the other-sites group; therefore, our algorithm for resecting HCC in the caudate lobe is of clinical use.