Safety and Effectiveness of Transarterial Chemoembolization for Caudate Lobe Hepatocellular Carcinoma: Long-Term...

To evaluate the safety and effectiveness of transarterial chemoembolization (TACE) as first-line treatment for single caudate lobe hepatocellular carcinoma (HCC).

A total of 107 treatment-naive patients who received TACE between 2006 and 2023 as first-line treatment for single caudate lobe HCC were retrospectively evaluated. Adverse events, radiologic tumor response, progression-free survival (PFS), and overall survival (OS) following TACE were investigated. Periprocedural variables related to complete response (CR) and OS were investigated using multivariable regression analyses.

Complete TACE (cisplatin, ethiodized oil, and gelatin foam particles) through all tumor-feeding caudate arteries was possible in 73% of the study patients. The severe adverse event rate was 2.8%. A CR at 1 month after TACE was achieved in 67% of the study patients, and multivariable analysis showed that complete TACE (P < .001; odds ratio [OR], 42.86) and a single tumor-feeding artery (P = .002; OR, 8.04) were significant predictors of a CR. The median PFS after TACE was 29 months. After TACE, the 3-, 5-, and 10-year OS rates were 62%, 46%, and 33%, respectively, and the median OS was 53 months. Multivariable analysis revealed 4 significant periprocedural risk factors: (a) incomplete TACE (P = .004; hazard ratio [HR], 2.69), (b) multiple tumor-feeding arteries (P = .04; HR, 2.02), (c) Child-Pugh Class B (P = .003; HR, 2.91), and (d) advanced-stage HCC (P = .02; HR, 3.43).

TACE appears to be a safe and potentially effective first-line treatment option, with long PFS, for patients with single HCC located in the caudate lobe.