Clinical Features and Surgical Outcome of Hepatic Caudate Lobe Metastases from Colorectal Cancer

Abstract

Background: The difficulty encountered in hepatectomy for the removal of a malignant tumor in the hepatic caudate lobe has recently been reported. However, few reports have described the clinical features of hepatic caudate lobe metastases from colorectal carcinoma. Patients and Methods: Retrospective clinicopathological data for 13 consecutive patients with colorectal metastases to the hepatic caudate lobe were analyzed for their various clinical aspects and long-term outcomes. Results: The tumor-free margin of the resected specimen was significantly smaller in the hepatic caudate lobe metastases group than in the other 178 patients with colorectal metastases in other sites of the liver (p<0.01), while the invasiveness of hepatectomy, as judged by the volume of liver resected and the duration of the procedure, was higher in the hepatic caudate lobe metastases group. Hepatic disease-free survival rates in the caudate lobe metastases group were lower than in the other group (p<0.01). By multivariate analysis, metastases to the hepatic caudate lobe negatively impacted hepatic disease-free survival (adjusted relative risk, 2.085; p=0.048). Conclusion: In patients with hepatic caudate lobe metastases, hepatectomy with clear surgical margins is difficult, even when major hepatectomy is attempted. Hepatic metastasis in the caudate lobe is a risk factor for early liver recurrence after hepatectomy.