Prognostic factors in the surgical treatment of caudate lobe hepatocellular carcinoma

Table 1 Clinical and pathologic characteristics of 114 HCC patients

Characteristics	n (%)
Age (yr)
≤ 65	89 (77)
> 65	25 (23)
Gender
Male	87 (76)
Female	27 (24)
Cirrhotic liver
No	36 (32)
Yes	78 (68)
Tumor size (cm)
≤ 5	50 (44)
> 5	64 (56)
Serum AFP (ng/mL)
≤ 200	69 (61)
> 200	45 (39)
Subsegmental location
Spiegel lobe	39 (34)
Paracaval portion	54 (47)
Caudate process	21 (19)
Tumor number
Solitary	91 (80)
Multiple	23 (20)
Pringle maneuver
No	34 (30)
Yes	80 (70)
Surgical treatment
Isolated caudate lobectomy	78 (68)
Extended hepatectomy	36 (32)
Surgical margin (mm)
≤ 5	47 (41)
> 5	67 (59)
Histologic grading
Differentiated	96 (84)
Undifferentiated	18 (16)
Capsule
No	95 (93)
Yes	19 (17)
Vascular invasion
No	71 (81)
Yes	43 (38)
Daughter nodules
No	83 (73)
Yes	31 (27)

HCC: Hepatocellular carcinoma; AFP: α-fetoprotein.

Table 2 Hepatectomy for caudate lobe hepatocellular carcinoma

Operations	n (%)
Isolated caudate lobectomy	78 (68.4)
Spiegel lobe	27
Paracaval portion and caudate process	31
Spiegel and paracaval portion	2
Paracaval portion	7
Caudate process	4
Complete caudate lobectomy	7
Extended hepatectomy	36 (31.6)
Spiegel and left hemihepatectomy	5
Spiegel and segment IV	2
Spiegel and II, III	3
Spiegel and VI, VII	1
Spiegel and VII	1
Paracaval portion and caudate process and right hemihepatectomy	4
Paracaval portion and caudate process and segment IV	2
Paracaval portion and caudate process and VII	1
Paracaval portion and caudate process and segment II, III	3
Paracaval portion and caudate process and V, VI	2
Paracaval portion and segment II, III	3
Paracaval portion and segment VI, VII	1
Complete caudate lobe and right hemihepatectomy	1
Complete caudate lobe and segment IV	1
Complete caudate lobe and left hemihepatectomy	4
Complete caudate lobe and segment II, III	1
Complete caudate lobe and segment VI	1

Table 3 Overall survival: univariate analysis of prognostic clinicopathologic factors

	3-yr survival (%)	5-yr survival (%)	P-value
Age (yr)
≤ 65	52.8	34.2	0.24
> 65	63.1	52.0
Gender
Male	56.1	38.4	0.41
Female	60.6	50.0
Cirrhosis
Yes	35.0	12.3	0.03
No	60.6	47.9
Serum AFP (ng/mL)
≤ 200	55.9	34.6	0.57
> 200	55.4	45.5
Tumor location
Spiegel lobe	63.1	45.7	0.01
Paracaval portion	22.9	16.2
Caudate process	25.2	14.9
Tumor size (cm)
≤ 5	58.4	43.3	0.48
> 5	57.0	39.4
Pringle maneuver
No	67.7	42.1	0.73
Yes	62.5	37.9
Surgical margin (mm)
≤ 5	20.4	18.5	0.02
> 5	60.7	54.6
Surgical treatment
Isolated caudate lobectomy	52.1	42.1	0.04
Extended hepatectomy	27.9	15.4
Histologic grading
Differentiated	57.7	33.6	0.79
Undifferentiated	52.2	29.4
Capsule
No	65.3	41.5	0.70
Yes	56.1	35.9
Vascular invasion
No	52.4	37.9	0.05
Yes	29.2	23.2
Daughter nodules
No	56.1	36.8	0.38
Yes	45.3	25.0

Table 4 Overall survival: multivariate analysis of prognostic clinicopathologic factors

	Hazard ratio	95% CI	P-value
Location of tumor	0.176	0.046-0.701	0.02
Liver cirrhosis	4.874	1.107-19.339	0.04
Surgical margin	1.36	0.210-2.375	0.04

Table 5 Disease-free survival: univariate analysis of prognostic clinicopathologic factors

	3-yr survival (%)	5-yr survival (%)	P-value
Age (yr)
≤ 62	46.7	21.7	0.76
> 62	38.2	31.4
Gender
Male	49.4	26.4	0.43
Female	25.1	20.7
Cirrhosis
Yes	42.6	37.2	0.19
No	51.9	29.3
Serum AFP (ng/mL)
≤ 200	36.5	20.1	0.66
> 200	32.4	29.7
Tumor location
Spiegel lobe	50.5	34.4	0.07
Paracaval portion	36.9	20.6
Caudate process	41.0	26.2
Tumor size (cm)
≤ 5	40.6	23.0	0.69
> 5	44.0	26.4
Pringle maneuver
No	40.4	22.6	0.66
Yes	36.1	19.8
Surgical margin
Positive	42.6	22.8	0.08
Negative	55.2	30.7
Surgical treatment
Isolated caudate lobectomy	43.4	24.0	0.35
Extended hepatectomy	41.7	35.8
Histologic grading
Differentiated	42.1	24.2	0.42
Undifferentiated	33.9	28.7
Capsule
No	36.3	19.0	0.65
Yes	43.8	26.3
Vascular invasion
No	45.0	29.7	0.25
Yes	34.0	21.3
Daughter nodules
No	56.1	36.8	0.09
Yes	45.3	25.0