Department of Radiology, Seoul National University College of Medicine; Institute of Radiation Medicine; Seoul National University Medical Research Center, Seoul, Korea.
Radiology. 2010 Oct;257(1):278-87. doi: 10.1148/radiol.10100105. Epub 2010 Aug 9.
To analyze the clinical outcomes of chemoembolization for solitary caudate lobe hepatocellular carcinoma (HCC) found at initial presentation.
This retrospective study was approved by the institutional review board; the requirement for informed patient consent was waived. From July 1998 to June 2009, 40 patients (28 men, 12 women; mean age, 57 years) found to have a single HCC lesion in the caudate lobe at initial presentation were treated with chemoembolization and evaluated for overall survival and progression-free survival. Multivariate analyses for potential clinical and radiologic factors were performed by using the Cox proportional hazard model.
Selective chemoembolization via the caudate artery was achieved in 34 (85%) patients. Overall survival rates at 1, 2, 3, 4, and 5 years were 92%, 79%, 65%, 56%, and 56%, respectively. Selective chemoembolization of the caudate artery was a critically important factor in longer overall survival (hazard ratio, 0.091; 95% confidence interval [CI]: 0.021, 0.389; P < .001), and portal vein tumor thrombosis (hazard ratio, 31.25; 95% CI: 4.88, 200.1; P < .001) and multiple tumor-feeding vessels (hazard ratio, 6.87; 95% CI: 1.47, 32.1; P = .014) were significant factors in shorter overall survival. Selective chemoembolization of the caudate artery was also a significant factor in longer progression-free survival (hazard ratio, 0.278; 95% CI: 0.10, 0.76; P = .013).
Selective chemoembolization via the caudate artery is possible in most patients with caudate lobe HCC and a critical factor in longer overall survival and longer progression-free survival.
分析初次就诊时单发尾状叶肝细胞癌（HCC）患者行化疗栓塞治疗的临床结果。
本回顾性研究经机构审查委员会批准，患者无需签署知情同意书。1998 年 7 月至 2009 年 6 月，40 例初次就诊时发现单发尾状叶 HCC 患者（28 例男性，12 例女性；平均年龄 57 岁）接受化疗栓塞治疗，评估其总生存率和无进展生存率。采用 Cox 比例风险模型进行潜在临床和影像学因素的多变量分析。
34 例（85%）患者成功经尾状动脉行选择性化疗栓塞。1、2、3、4 和 5 年总生存率分别为 92%、79%、65%、56%和 56%。选择性尾状动脉化疗栓塞是总生存时间延长的关键因素（风险比，0.091；95%置信区间：0.021，0.389；P<0.001），门静脉癌栓（风险比，31.25；95%置信区间：4.88，200.1；P<0.001）和多发肿瘤供养血管（风险比，6.87；95%置信区间：1.47，32.1；P=0.014）是总生存时间缩短的显著因素。选择性尾状动脉化疗栓塞也是无进展生存时间延长的显著因素（风险比，0.278；95%置信区间：0.10，0.76；P=0.013）。
大多数尾状叶 HCC 患者可经尾状动脉行选择性化疗栓塞，该方法是总生存时间延长和无进展生存时间延长的关键因素。
