Related Experiment Video
Updated: Jun 3, 2026
Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
Surgical treatment of huge hepatocellular carcinoma in the caudate lobe
Peng Liu1, Jiamei Yang, Wenyan Niu
1Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225 Changhai Road, Shanghai, 200438, PR China.
Insights
Aggressive liver surgery for huge hepatocellular carcinoma (HCC) in the caudate lobe offers long-term survival for selected patients. Despite a 33.3% complication rate, surgical intervention demonstrates significant patient outcomes.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastroenterology
Background:
- Huge hepatocellular carcinoma (HCC) in the caudate lobe presents unique surgical challenges.
- Effective management strategies for caudate lobe HCC are crucial for patient survival.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of surgical interventions for large HCCs located in the caudate lobe of the liver.
- To determine the feasibility and long-term results of aggressive surgical approaches for this specific HCC subtype.
Main Methods:
- Retrospective analysis of 18 patients with huge caudate lobe HCC who underwent surgical treatment.
- Classification of surgical procedures into isolated caudate lobectomy or extended caudate lobectomy (9 patients each).
- Documentation of intraoperative/postoperative complications, recurrence treatments, and survival analysis using Kaplan-Meier method.
Main Results:
- Postoperative mortality was 0%, with a morbidity rate of 33.3%.
- Tumor recurrence occurred in 77% of patients, with various treatments including TACE, PЕIT, radiotherapy, chemotherapy, liver transplantation, and repeat resection.
- Overall survival rates at 1, 3, and 5 years were 83%, 47%, and 31%, respectively.
Conclusions:
- An aggressive surgical strategy can lead to long-term survival in carefully selected patients with huge HCC in the caudate lobe.
- Despite high recurrence rates, multidisciplinary management of recurrence contributes to sustained survival.
- Surgical resection remains a viable option for managing complex caudate lobe HCC cases.
Purpose:
To assess the outcome and effectiveness of liver surgery for huge hepatocellular carcinoma (HCC) in the caudate lobe.
Methods:
This study retrospectively examined 18 patients who underwent surgical treatment for huge HCC in the caudate lobe. An isolated caudate lobectomy and an extended caudate lobectomy were each performed in nine patients (50%). The intraoperative and postoperative complications and treatments for recurrence were recorded. The survival curve was estimated using the Kaplan-Meier method.
Results:
The postoperative mortality and morbidity were nil and 33.3%, respectively. Fourteen patients (77%) had tumor recurrence as of the last follow-up. The recurrence was treated in all patients. Eleven patients underwent transcatheter arterial chemoembolization, a median of three times per patient (range, 1-7); one of those patients also received percutaneous ethanol injection therapy and radiotherapy of recurrent nodules. One patient was treated with systemic chemotherapy. One patient underwent liver transplantation, and one underwent a repeated liver resection. The overall survival rates at 1, 3, and 5 years were 83%, 47%, and 31%, respectively.
Conclusion:
Long-term survival can be achieved using an aggressive surgical approach in selected patients with huge HCC in the caudate lobe.
