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

  • Nao Yoshida
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan
  • Yutaka Midorikawa
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan
  • Tokio Higaki
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan
  • Hisashi Nakayama
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan
  • Masamichi Moriguchi
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan
  • Osamu Aramaki
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan
  • Shingo Tsuji
    Research Center for Advanced Science and Technology Genome Science Division, University of Tokyo 153‐8904 Tokyo Japan
  • Yukiyasu Okamura
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan
  • Tadatoshi Takayama
    Department of Digestive Surgery Nihon University School of Medicine 30‐1, Oyaguchikami‐machi, Itabashi‐ku 173‐8610 Tokyo Japan

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<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>After one‐to‐one matching, the caudate‐lobe group (<jats:italic>n</jats:italic> = 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 (<jats:italic>n</jats:italic> = 150), but the complication rates were not different between the groups (38.0% vs. 34.1%, <jats:italic>P</jats:italic> = 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 (<jats:italic>P</jats:italic> = 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) (<jats:italic>P</jats:italic> = 0.052).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>

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