Skip to main content
Log in

Chemoembolization of Extrahepatic Collateral Arteries for Treatment of Hepatocellular Carcinoma in the Caudate Lobe of the Liver

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to evaluate the efficacy and safety in performing chemoembolization of extrahepatic collateral arteries (EHC) for hepatocellular carcinoma (HCC) located in the caudate lobe.

Methods

Between January 2006 and November 2013, chemoembolization via EHC was performed in 35 patients with 35 caudate HCCs. Preprocedural and follow-up CT or MR scans, angiographic images, and medical records were reviewed retrospectively in consensus. Chi-square analysis was used to evaluate the relationship between tumor characteristics and type of EHC and that between tumor response and the characteristics of the tumor and chemoembolization.

Results

In 31 (88.6 %) patients, EHCs supplying the caudate HCC originated from the right inferior phrenic artery (RIPA). The remaining four HCCs were supplied by the gastroduodenal artery, dorsal pancreatic artery, and right and left gastric arteries. Superselective catheterization of tumor-feeding vessels from the EHC was achieved in 27 patients (77.1 %). There were no major complications. Individual tumor response supplied by the EHC at follow-up contrast-enhanced CT were as follows: complete response (n = 18), partial response (n = 9), stable disease (n = 3), and progressive disease (n = 3). Non-RIPA EHCs were significantly more common in patients who had previously received chemoembolization via the RIPA (50 %) than those who had not (6.5 %; P = 0.01). There was no significant predictive factor associated with tumor response.

Conclusions

HCC in the caudate lobe can be supplied by several EHCs. Chemoembolization via these arteries can be performed safely and effectively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Tanaka S, Shimada M, Shirabe K et al (2005) Surgical outcome of patients with hepatocellular carcinoma originating in the caudate lobe. Am J Surg 190:451–455

    Article  PubMed  Google Scholar 

  2. Lu CL, Wu JC, Chiang JH et al (1997) Hepatocellular carcinoma in the caudate lobe: early diagnosis and active treatment may result in long-term survival. J Gastroenterol Hepatol 12:144–148

    Article  CAS  PubMed  Google Scholar 

  3. Chaib E, Ribeiro MA Jr, Silva Fde S et al (2007) Surgical approach for hepatic caudate lobectomy: review of 401 cases. J Am Coll Surg 204:118–127

    Article  PubMed  Google Scholar 

  4. Sakamoto Y, Nara S, Hata S et al (2011) Prognosis of patients undergoing hepatectomy for solitary hepatocellular carcinoma originating in the caudate lobe. Surgery 150:959–967

    Article  PubMed  Google Scholar 

  5. Seror O, Haddar D, N’Kontchou G et al (2005) Radiofrequency ablation for the treatment of liver tumors in the caudate lobe. J Vasc Interv Radiol 16:981–990

    Article  PubMed  Google Scholar 

  6. Yamakado K, Nakatsuka A, Akeboshi M et al (2005) Percutaneous radiofrequency ablation for the treatment of liver neoplasms in the caudate lobe left of the vena cava: electrode placement through the left lobe of the liver under CT-fluoroscopic guidance. Cardiovasc Intervent Radiol 28:638–640

    Article  PubMed  Google Scholar 

  7. Terayama N, Miyayama S, Tatsu H et al (1998) Subsegmental transcatheter arterial embolization for hepatocellular carcinoma in the caudate lobe. J Vasc Interv Radiol 9:501–508

    Article  CAS  PubMed  Google Scholar 

  8. Kim HC, Chung JW, Jae HJ et al (2010) Caudate lobe hepatocellular carcinoma treated with selective chemoembolization. Radiology 257:278–287

    Article  PubMed  Google Scholar 

  9. Miyayama S, Yamashiro M, Hattori Y et al (2011) Angiographic evaluation of feeding arteries of hepatocellular carcinoma in the caudate lobe of the liver. Cardiovasc Intervent Radiol 34:1244–1253

    Article  PubMed  Google Scholar 

  10. Yoon CJ, Chung JW, Cho BH et al (2008) Hepatocellular carcinoma in the caudate lobe of the liver: angiographic analysis of tumor-feeding arteries according to subsegmental location. J Vasc Interv Radiol 19:1543–1550

    Article  PubMed  Google Scholar 

  11. Choi JW, Kim HC, Chung JW et al (2012) Chemoembolization via branches from the splenic artery in patients with hepatocellular carcinoma. Cardiovasc Intervent Radiol 35:90–96

    Article  PubMed  Google Scholar 

  12. Kim HC, Chung JW, Lee IJ et al (2011) Intercostal artery supplying hepatocellular carcinoma: demonstration of a tumor feeder by C-arm CT and multidetector row CT. Cardiovasc Intervent Radiol 34:87–91

    Article  PubMed  Google Scholar 

  13. Miyayama S, Matsui O, Taki K et al (2006) Extrahepatic blood supply to hepatocellular carcinoma: angiographic demonstration and transcatheter arterial chemoembolization. Cardiovasc Intervent Radiol 29:39–48

    Article  PubMed  Google Scholar 

  14. Hur S, Kim HC, Chung JW et al (2011) Hepatocellular carcinomas smaller than 4 cm supplied by the intercostal artery: can we predict which intercostal artery supplies the tumor? Korean J Radiol 12:693–699

    Article  PubMed Central  PubMed  Google Scholar 

  15. Kim HC, Chung JW, An S et al (2011) Transarterial chemoembolization of a colic branch of the superior mesenteric artery in patients with unresectable hepatocellular carcinoma. J Vasc Interv Radiol 22:47–54

    Article  CAS  PubMed  Google Scholar 

  16. Loukas M, Hullett J, Wagner T (2005) Clinical anatomy of the inferior phrenic artery. Clin Anat 18:357–365

    Article  PubMed  Google Scholar 

  17. Gwon DI, Ko GY, Yoon HK et al (2007) Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics 27:687–705

    Article  PubMed  Google Scholar 

  18. Miyayama S, Yamashiro M, Shibata Y et al (2012) Arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery in patients with recurrent hepatocellular carcinoma after chemoembolization. Jpn J Radiol 30:45–52

    Article  PubMed  Google Scholar 

  19. Miyayama S, Yamashiro M, Yoshie Y et al (2010) Hepatocellular carcinoma in the caudate lobe of the liver: variations of its feeding branches on arteriography. Jpn J Radiol 28:555–562

    Article  PubMed  Google Scholar 

  20. Kim HC, Chung JW, Lee W et al (2005) Recognizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcatheter arterial chemoembolization. Radiographics 25:S25–S39

    Article  PubMed  Google Scholar 

  21. Choi WS, Kim H-C, Hur S et al (2014) Role of C-Arm CT in identifying caudate arteries supplying hepatocellular carcinoma. J Vasc Interv Radiol. doi:10.1016/j.jvir.2014.02.028

  22. Kim HC, Chung JW, An S et al (2008) Hepatocellular carcinoma: detection of blood supply from the right inferior phrenic artery by the use of multi-detector row CT. J Vasc Interv Radiol 19:1551–1557

    Article  PubMed  Google Scholar 

  23. Kumon M (1985) Anatomy of the caudate lobe with special reference to portal vein and bile duct. Acta Hepatol Jpn 26:1193–1199

    Article  Google Scholar 

  24. Sacks D, McClenny TE, Cardella JF et al (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202

    Article  PubMed  Google Scholar 

  25. Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30:52–60

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2A10011007).

Conflict of interest

Sungmin Woo, Hyo-Cheol Kim, Jin Wook Chung, Hyun-Seok Jung, Saebeom Hur, Myungsu Lee and Hwan Jun Jae have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hyo-Cheol Kim.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Woo, S., Kim, HC., Chung, J.W. et al. Chemoembolization of Extrahepatic Collateral Arteries for Treatment of Hepatocellular Carcinoma in the Caudate Lobe of the Liver. Cardiovasc Intervent Radiol 38, 389–396 (2015). https://doi.org/10.1007/s00270-014-0929-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-014-0929-7

Keywords

Navigation