Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 2/2015

01.04.2015 | Clinical Investigation

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

verfasst von: Sungmin Woo, Hyo-Cheol Kim, Jin Wook Chung, Hyun-Seok Jung, Saebeom Hur, Myungsu Lee, Hwan Jun Jae

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 2/2015

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Tanaka S, Shimada M, Shirabe K et al (2005) Surgical outcome of patients with hepatocellular carcinoma originating in the caudate lobe. Am J Surg 190:451–455CrossRefPubMed Tanaka S, Shimada M, Shirabe K et al (2005) Surgical outcome of patients with hepatocellular carcinoma originating in the caudate lobe. Am J Surg 190:451–455CrossRefPubMed
2.
Zurück zum Zitat 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 12:144–148CrossRefPubMed 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 12:144–148CrossRefPubMed
3.
Zurück zum Zitat 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 204:118–127CrossRefPubMed 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 204:118–127CrossRefPubMed
4.
Zurück zum Zitat Sakamoto Y, Nara S, Hata S et al (2011) Prognosis of patients undergoing hepatectomy for solitary hepatocellular carcinoma originating in the caudate lobe. Surgery 150:959–967CrossRefPubMed Sakamoto Y, Nara S, Hata S et al (2011) Prognosis of patients undergoing hepatectomy for solitary hepatocellular carcinoma originating in the caudate lobe. Surgery 150:959–967CrossRefPubMed
5.
Zurück zum Zitat 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 16:981–990CrossRefPubMed 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 16:981–990CrossRefPubMed
6.
Zurück zum Zitat 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 28:638–640CrossRefPubMed 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 28:638–640CrossRefPubMed
7.
Zurück zum Zitat Terayama N, Miyayama S, Tatsu H et al (1998) Subsegmental transcatheter arterial embolization for hepatocellular carcinoma in the caudate lobe. J Vasc Interv Radiol 9:501–508CrossRefPubMed Terayama N, Miyayama S, Tatsu H et al (1998) Subsegmental transcatheter arterial embolization for hepatocellular carcinoma in the caudate lobe. J Vasc Interv Radiol 9:501–508CrossRefPubMed
8.
Zurück zum Zitat Kim HC, Chung JW, Jae HJ et al (2010) Caudate lobe hepatocellular carcinoma treated with selective chemoembolization. Radiology 257:278–287CrossRefPubMed Kim HC, Chung JW, Jae HJ et al (2010) Caudate lobe hepatocellular carcinoma treated with selective chemoembolization. Radiology 257:278–287CrossRefPubMed
9.
Zurück zum Zitat 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 34:1244–1253CrossRefPubMed 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 34:1244–1253CrossRefPubMed
10.
Zurück zum Zitat 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 19:1543–1550CrossRefPubMed 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 19:1543–1550CrossRefPubMed
11.
Zurück zum Zitat Choi JW, Kim HC, Chung JW et al (2012) Chemoembolization via branches from the splenic artery in patients with hepatocellular carcinoma. Cardiovasc Intervent Radiol 35:90–96CrossRefPubMed Choi JW, Kim HC, Chung JW et al (2012) Chemoembolization via branches from the splenic artery in patients with hepatocellular carcinoma. Cardiovasc Intervent Radiol 35:90–96CrossRefPubMed
12.
Zurück zum Zitat 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 34:87–91CrossRefPubMed 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 34:87–91CrossRefPubMed
13.
Zurück zum Zitat Miyayama S, Matsui O, Taki K et al (2006) Extrahepatic blood supply to hepatocellular carcinoma: angiographic demonstration and transcatheter arterial chemoembolization. Cardiovasc Intervent Radiol 29:39–48CrossRefPubMed Miyayama S, Matsui O, Taki K et al (2006) Extrahepatic blood supply to hepatocellular carcinoma: angiographic demonstration and transcatheter arterial chemoembolization. Cardiovasc Intervent Radiol 29:39–48CrossRefPubMed
14.
Zurück zum Zitat 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 12:693–699CrossRefPubMedCentralPubMed 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 12:693–699CrossRefPubMedCentralPubMed
15.
Zurück zum Zitat 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 22:47–54CrossRefPubMed 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 22:47–54CrossRefPubMed
16.
Zurück zum Zitat Loukas M, Hullett J, Wagner T (2005) Clinical anatomy of the inferior phrenic artery. Clin Anat 18:357–365CrossRefPubMed Loukas M, Hullett J, Wagner T (2005) Clinical anatomy of the inferior phrenic artery. Clin Anat 18:357–365CrossRefPubMed
17.
Zurück zum Zitat Gwon DI, Ko GY, Yoon HK et al (2007) Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics 27:687–705CrossRefPubMed Gwon DI, Ko GY, Yoon HK et al (2007) Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics 27:687–705CrossRefPubMed
18.
Zurück zum Zitat 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 30:45–52CrossRefPubMed 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 30:45–52CrossRefPubMed
19.
Zurück zum Zitat 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 28:555–562CrossRefPubMed 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 28:555–562CrossRefPubMed
20.
Zurück zum Zitat 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–S39CrossRefPubMed 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–S39CrossRefPubMed
22.
Zurück zum Zitat 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 19:1551–1557CrossRefPubMed 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 19:1551–1557CrossRefPubMed
23.
Zurück zum Zitat Kumon M (1985) Anatomy of the caudate lobe with special reference to portal vein and bile duct. Acta Hepatol Jpn 26:1193–1199CrossRef Kumon M (1985) Anatomy of the caudate lobe with special reference to portal vein and bile duct. Acta Hepatol Jpn 26:1193–1199CrossRef
24.
Zurück zum Zitat Sacks D, McClenny TE, Cardella JF et al (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202CrossRefPubMed Sacks D, McClenny TE, Cardella JF et al (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202CrossRefPubMed
25.
Zurück zum Zitat Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30:52–60CrossRefPubMed Lencioni R, Llovet JM (2010) Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 30:52–60CrossRefPubMed
Metadaten
Titel
Chemoembolization of Extrahepatic Collateral Arteries for Treatment of Hepatocellular Carcinoma in the Caudate Lobe of the Liver
verfasst von
Sungmin Woo
Hyo-Cheol Kim
Jin Wook Chung
Hyun-Seok Jung
Saebeom Hur
Myungsu Lee
Hwan Jun Jae
Publikationsdatum
01.04.2015
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 2/2015
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-014-0929-7

Weitere Artikel der Ausgabe 2/2015

CardioVascular and Interventional Radiology 2/2015 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.