1–3 Over the past decade, advances in surgical techniques, patient selection, and perioperative management have significantly reduced surgical mortality to below 3% at specialized hepatobiliary centers.
1, 2 Surgical resection is considered to be the mainstay of potentially curative therapy for patients with localized HCC and preserved liver function. Hepatocellular carcinoma (HCC) is the most frequent primary liver malignancy and ranks sixth most common malignancy, with an increasing incidence worldwide. Keywords: hepatocellular carcinoma, caudate lobe, surgery, outcomes, meta-analysis Meta-analysis revealed that CCL provided better RFS (hazard ratio 0.54, 95% confidence interval 0.31– 0.92) than ICL no significant differences were observed in OS, operation time, blood loss and morbidity rate.Ĭonclusion: CCL confers superior RFS over ICL without compromise of perioperative outcomes and should be prioritized for patients with caudate HCC when feasible, especially for those with large-sized tumors. A total of 227 patients from nine eligible studies and ours were involved in the systematic review. In the well-matched cohort, CCL demonstrated significantly improved recurrence-free survival (RFS) ( P = 0.047) compared with ICL no significant differences were noted for overall survival (OS), operation time, blood loss and morbidity rate. After propensity score matching, 6 pairs of patients were selected. Compared with ICL, the CCL group contained patients with larger tumors and a higher incidence of vascular invasion. Results: A total of 28 patients were included: 11 in the CCL and 17 in the ICL group. A systematic review with meta-analysis was also performed to compare outcomes of CCL versus ICL for caudate HCC. Surgical outcomes of the two strategy groups were analyzed before and after propensity score matching. Methods: Patients who underwent curative-intent resection for caudate HCC between January 2010 and December 2018 were identified from a single-center database. We aimed to evaluate the relative benefits of combined caudate lobectomy (CCL) versus isolated caudate lobectomy (ICL) for caudate HCC. Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People’s Republic of China, Tel +86 18061675088 +86 15951758275, Fax +86 68136450, Email īackground: Resection of hepatocellular carcinoma (HCC) originating in the caudate lobe remains challenging, while the optimal extent of resection is debated. *These authors contributed equally to this work Zheng-Gang Xu, 1– 3, * Fei-Hong Zhang, 1– 3, * Dong-Wei Sun, 1– 3, * Qi-Tong Zheng, 1– 3 Gu-Wei Ji, 1– 3 Ke Wang 1– 3ġHepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China 2Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, People’s Republic of China 3NHC Key Laboratory of Living Donor Liver Transplantation (Nanjing Medical University), Nanjing, People’s Republic of China