Hwan Jun Jae MD, Presenter: Nothing to Disclose

Jin Wook Chung, Abstract Co-Author: Nothing to Disclose

Hurn Hur, Abstract Co-Author: Nothing to Disclose

Chang Jin Yoon, Abstract Co-Author: Nothing to Disclose

Whal Lee MD, Abstract Co-Author: Nothing to Disclose

Jae Hyung Park, Abstract Co-Author: Nothing to Disclose

Hepatocellular carcinoma (HCC) originating in the caudate lobe is rare and treatment for caudate HCC was thought difficult, because of its unique location and complex arterial supply. The aim of this study was to evaluate the feasibility and results of superselective transcatheter arterial chemoembolization (TACE) in HCC located in the caudate lobe of the liver.

Between January 1998 to March 2004, 3433 patients underwent TACE for HCC and 164 patients had caudate HCC. Among them, 57 patients (42 male, 15 female, mean age 57 years) who had a solitary nodule in the caudate lobe were included in this study. Thirty-six patients had a primary HCC in the caudate lobe and 21 patients had a recurrent HCC after hepatic resection or TACE or percutaneous ethanol injection therapy. The mean tumor size was 3.1 cm (range 1 to 7 cm) and Child-Pugh classification of the patients was grade A in 38 patients, grade B 1n 16, and grade C in 3. In all patients, selective hepatic arteriography was performed to identify tumor feeders and superselective catheterization of identified tumor feeders was attempted for superselective TACE. We analyzed the feasibility of superselective TACE in the 57 patients and tumor response in 29 patients who were followed up for more than 6 months without surgical resection (range 6 to 84 months, mean 30).

Superselective TACE through identified tumor feeders was possible in 47 cases (82%), and in the remaining 10 cases TACE was performed at the arterial segment proximal to the origin of tumor feeders. Among the 29 patients with at least 6-month follow-up without surgery, complete remission of the caudate HCC was achieved in superselective TACE group (n=24) in 17 patients (71%) and non-superselective TACE group (n=5) in 2 (40%). Overall remote site recurrence developed in 16 patients (55%).

Caudate HCC can be effectively managed by superselective TACE in most cases. The therapeutic result seems to be equal to segmental TACE for HCC at other hepatic segments.

Jae, H, Chung, J, Hur, H, Yoon, C, Lee, W, Park, J, Superselective Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma in the Caudate Lobe of the Liver.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4417176.html