| Popis: |
Background Treatment of hepatocellular carcinoma (HCC) in the caudate lobe is technically challenging. This retrospective study aims to evaluate the clinical outcome of both super selective transcatheter arterial chemoembolization (TACE) and liver resection (LR) for HCC occurring in the caudate lobe. Methods From January 2008 to September 2021, a total of 129 patients were diagnosed with HCC exclusively located in the caudate lobe. We used the Cox proportional hazard model to analyze the potential clinical factors and established prognostic nomograms with interval validation. Results 78 patients received TACE, and 51 patients received LR. The overall survival (OS) rates (TACE vs. LR) at 1, 2, 3, 4, and 5 years were 83.9% vs. 71.0%, 74.2% vs. 61.3%, 58.1% vs. 48.4%, 45.2% vs. 45.2%, and 32.3% vs. 25.0%, respectively. However, the subgroup analysis revealed that TACE is superior to LR for treating patients with BCLC-B stage in the entire cohort (P = 0.002). Interestingly, we found no difference in BCLC-A stage HCC between TACE and LR (P = 0.6). Based on Child-Pugh A and B, TACE tends to have better OS than LR (P = 0.081) and (P = 0.16), respectively. The multivariate analysis showed Child-Pugh score, Barcelona Clinic Liver Cancer (BCLC) stage, ascites, alpha fetoprotein (AFP), the largest tumor size, and anti-HsCV is related to OS. Predictive nomograms for 1-, 2-, 3- years were performed. Conclusion Based on this study, TACE may be better for HCC in the caudal lobe than liver resection, considering a longer overall survival time. |
