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ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study
J. Li, M. Moustafa, M. Linecker, G. Lurje, I. Capobianco, J. Baumgart, F. Ratti, F. Rauchfuss, D. Balci, E. Fernandes, R. Montalti, R. Robles-Campos, B. Bjornsson, SA. Topp, J. Fronek, C. Liu, R. Wahba, C. Bruns, SM. Brunner, HJ. Schlitt, A....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
NLK
Free Medical Journals
od 1994 do Před 24 měsíci
ProQuest Central
od 1997-01-01 do Před 1 rokem
Medline Complete (EBSCOhost)
od 2009-07-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 1997-01-01 do Před 1 rokem
- MeSH
- ascites epidemiologie MeSH
- cholangiokarcinom chirurgie MeSH
- dospělí MeSH
- hepatektomie metody MeSH
- infekce chirurgické rány epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- ligace MeSH
- mezinárodní spolupráce MeSH
- míra přežití MeSH
- nádory žlučových cest chirurgie MeSH
- paliativní péče MeSH
- pooperační komplikace epidemiologie prevence a kontrola MeSH
- pooperační krvácení epidemiologie MeSH
- program SEER MeSH
- proporcionální rizikové modely MeSH
- protinádorové látky terapeutické užití MeSH
- registrace MeSH
- selhání jater prevence a kontrola MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- tendenční skóre MeSH
- vena portae chirurgie MeSH
- výsledek terapie MeSH
- žlučové cesty intrahepatální * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: ALPPS is found to increase the resectability of primary and secondary liver malignancy at the advanced stage. The aim of the study was to verify the surgical and oncological outcome of ALPPS for intrahepatic cholangiocarcinoma (ICC). METHODS: The study cohort was based on the ALPPS registry with patients from 31 international centers between August 2009 and January 2018. Propensity score matched patients receiving chemotherapy only were selected from the SEER database as controls for the survival analysis. RESULTS: One hundred and two patients undergoing ALPPS were recruited, 99 completed the second stage with median inter-stage duration of 11 days. The median kinetic growth rate was 23 ml/day. R0 resection was achieved in 87 (85%). Initially high rates of morbidity and mortality decreased steadily to a 29% severe complication rate and 7% 90-day morbidity in the last 2 years. Post-hepatectomy liver failure remained the main cause of 90-day mortality. Multivariate analysis revealed insufficient future liver remnant at the stage-2 operation (FLR2) to be the only risk factor for severe complications (OR 2.91, p = 0.02). The propensity score matching analysis showed a superior overall survival in the ALPPS group compared to palliative chemotherapy (median overall survival: 26.4 months vs 14 months; 1-, 2-, and 3-year survival rates: 82.4%, 70.5% and 39.6% vs 51.2%, 21.4% and 11.3%, respectively, p < 0.01). The survival benefit, however, was not confirmed in the subgroup analysis for patients with insufficient FLR2 or multifocal ICC. CONCLUSION: ALPPS showed high efficacy in achieving R0 resections in locally advanced ICC. To get the most oncological benefit from this aggressive surgery, ALPPS would be restricted to patients with single lesions and sufficient FLR2.
1st Department of Surgery Semmelweis University Budapest Hungary
Centre Hépato Biliaire AP HP Hôpital Paul Brousse Inserm U 935 Univ Paris Saclay Villejuif France
Department of General Surgery Nicosia Teaching Hospital Strovolos Cyprus
Department of General Visceral and endocrine Surgery München Klinik Neuperlach Munich Germany
Department of General Visceral and Transplantation Surgery University Hospital Mainz Mainz Germany
Department of General Visceral and Vascular Surgery University Hospital Jena Jena Germany
Department of Human Structure and Repair Faculty of Medicine Ghent University Ghent Belgium
Department of Public Health Federico 2 University Hospital Naples Italy
Department of Surgery and Transplantation University Hospital RWTH Aachen Aachen Germany
Department of Surgery Ankara University Ankara Turkey
Department of Surgery Shinshu University School of Medicine Matsumoto Japan
Department of Surgery University College London London UK
Department of Surgery University Medical Center Regensburg Regensburg Germany
Department of Surgery Virgen de la Arrixaca Hospital IMIB Arrixaca Murcia Spain
Division of Transplantation and Hepatobiliary Surgery University of Rochester Rochester NY USA
Hepatobiliary Surgery and Liver Transplant Unit University of Padua Padua Italy
Hepatobiliary Surgery Division San Raffaele Hospital Milan Italy
HPB Surgery and Liver Transplant Unit Italian Hospital Buenos Aires Buenos Aires Argentina
Citace poskytuje Crossref.org
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- $a Li, Jun $u Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. j.li@uke.de.
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- $a ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study / $c J. Li, M. Moustafa, M. Linecker, G. Lurje, I. Capobianco, J. Baumgart, F. Ratti, F. Rauchfuss, D. Balci, E. Fernandes, R. Montalti, R. Robles-Campos, B. Bjornsson, SA. Topp, J. Fronek, C. Liu, R. Wahba, C. Bruns, SM. Brunner, HJ. Schlitt, A. Heumann, BO. Stüben, JR. Izbicki, J. Bednarsch, E. Gringeri, E. Fasolo, J. Rolinger, J. Kristek, R. Hernandez-Alejandro, A. Schnitzbauer, N. Nuessler, MR. Schön, S. Voskanyan, AS. Petrou, O. Hahn, Y. Soejima, E. Vicente, C. Castro-Benitez, R. Adam, F. Tomassini, RI. Troisi, A. Kantas, KJ. Oldhafer, V. Ardiles, E. de Santibanes, M. Malago, PA. Clavien, M. Vivarelli, U. Settmacher, L. Aldrighetti, U. Neumann, H. Petrowsky, U. Cillo, H. Lang, S. Nadalin,
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- 700 1_
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- 700 1_
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