The role of ALPPS in intrahepatic cholangiocarcinoma

Jan Bednarsch; Zoltan Czigany; Isabella Lurje; Pavel Strnad; Philipp Bruners; Tom Florian Ulmer; Marcel den Dulk; Georg Lurje; Ulf Peter Neumann

doi:10.1007/s00423-019-01838-2

The role of ALPPS in intrahepatic cholangiocarcinoma

Jan Bednarsch, Zoltan Czigany, Isabella Lurje, Pavel Strnad, Philipp Bruners, Tom Florian Ulmer, Marcel den Dulk, Georg Lurje^*, Ulf Peter Neumann

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Purpose Surgical resection constitutes the mainstay of curative treatment for intrahepatic cholangiocarcinoma (iCCA). Complete tumor clearance can only be achieved with extended liver resections and as such, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) may facilitate surgical resectability. The present study aims to evaluate the technical feasibility and oncologic outcome of ALPPS in iCCA. Methods A set of 14 patients who underwent ALPPS in a single center between 2011 and 2017 were statistically analyzed for perioperative and oncologic outcome. Results Of all patients undergoing stage 1 of ALPPS, 12 (86%) patients were subsequently completed in stage 2 surgery. Patients who completed the ALPPS procedure showed a median overall survival (OS) of 4.2 years and a 3-year survival of 64%. Individuals without lymphatic metastases (n = 7) were all alive 1 year after surgery and if deceased, they died more than 4 years after surgery, while no patient with lymphatic metastases (n = 5) was alive 1 year after surgery. Conclusion This is the largest single-center experience of ALPPS in iCCA currently available in the literature showing excellent technical feasibility and encouraging overall survival in these patients.

Original language	English
Pages (from-to)	885-894
Number of pages	10
Journal	Langenbeck's Archives of Surgery
Volume	404
Issue number	7
DOIs	https://doi.org/10.1007/s00423-019-01838-2
Publication status	Published - Nov 2019

Keywords

Intrahepatic cholangiocarcinoma (iCCA)
ALPPS
Oncological outcome
PORTAL-VEIN LIGATION
ASSOCIATING LIVER PARTITION
SURGICAL-TREATMENT
STAGED HEPATECTOMY
PROGNOSTIC-FACTORS
RISK-FACTORS
DIAGNOSIS
SURVIVAL
RESECTIONS
METASTASES

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title = "The role of ALPPS in intrahepatic cholangiocarcinoma",

abstract = "Purpose Surgical resection constitutes the mainstay of curative treatment for intrahepatic cholangiocarcinoma (iCCA). Complete tumor clearance can only be achieved with extended liver resections and as such, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) may facilitate surgical resectability. The present study aims to evaluate the technical feasibility and oncologic outcome of ALPPS in iCCA. Methods A set of 14 patients who underwent ALPPS in a single center between 2011 and 2017 were statistically analyzed for perioperative and oncologic outcome. Results Of all patients undergoing stage 1 of ALPPS, 12 (86%) patients were subsequently completed in stage 2 surgery. Patients who completed the ALPPS procedure showed a median overall survival (OS) of 4.2 years and a 3-year survival of 64%. Individuals without lymphatic metastases (n = 7) were all alive 1 year after surgery and if deceased, they died more than 4 years after surgery, while no patient with lymphatic metastases (n = 5) was alive 1 year after surgery. Conclusion This is the largest single-center experience of ALPPS in iCCA currently available in the literature showing excellent technical feasibility and encouraging overall survival in these patients.",

keywords = "Intrahepatic cholangiocarcinoma (iCCA), ALPPS, Oncological outcome, PORTAL-VEIN LIGATION, ASSOCIATING LIVER PARTITION, SURGICAL-TREATMENT, STAGED HEPATECTOMY, PROGNOSTIC-FACTORS, RISK-FACTORS, DIAGNOSIS, SURVIVAL, RESECTIONS, METASTASES",

author = "Jan Bednarsch and Zoltan Czigany and Isabella Lurje and Pavel Strnad and Philipp Bruners and Ulmer, {Tom Florian} and {den Dulk}, Marcel and Georg Lurje and Neumann, {Ulf Peter}",

note = "Publisher Copyright: {\textcopyright} 2019, Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2019",

month = nov,

doi = "10.1007/s00423-019-01838-2",

language = "English",

volume = "404",

pages = "885--894",

journal = "Langenbeck's Archives of Surgery",

issn = "1435-2443",

publisher = "Springer",

number = "7",

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T1 - The role of ALPPS in intrahepatic cholangiocarcinoma

AU - Bednarsch, Jan

AU - Czigany, Zoltan

AU - Lurje, Isabella

AU - Strnad, Pavel

AU - Bruners, Philipp

AU - Ulmer, Tom Florian

AU - den Dulk, Marcel

AU - Lurje, Georg

AU - Neumann, Ulf Peter

PY - 2019/11

Y1 - 2019/11

N2 - Purpose Surgical resection constitutes the mainstay of curative treatment for intrahepatic cholangiocarcinoma (iCCA). Complete tumor clearance can only be achieved with extended liver resections and as such, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) may facilitate surgical resectability. The present study aims to evaluate the technical feasibility and oncologic outcome of ALPPS in iCCA. Methods A set of 14 patients who underwent ALPPS in a single center between 2011 and 2017 were statistically analyzed for perioperative and oncologic outcome. Results Of all patients undergoing stage 1 of ALPPS, 12 (86%) patients were subsequently completed in stage 2 surgery. Patients who completed the ALPPS procedure showed a median overall survival (OS) of 4.2 years and a 3-year survival of 64%. Individuals without lymphatic metastases (n = 7) were all alive 1 year after surgery and if deceased, they died more than 4 years after surgery, while no patient with lymphatic metastases (n = 5) was alive 1 year after surgery. Conclusion This is the largest single-center experience of ALPPS in iCCA currently available in the literature showing excellent technical feasibility and encouraging overall survival in these patients.

AB - Purpose Surgical resection constitutes the mainstay of curative treatment for intrahepatic cholangiocarcinoma (iCCA). Complete tumor clearance can only be achieved with extended liver resections and as such, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) may facilitate surgical resectability. The present study aims to evaluate the technical feasibility and oncologic outcome of ALPPS in iCCA. Methods A set of 14 patients who underwent ALPPS in a single center between 2011 and 2017 were statistically analyzed for perioperative and oncologic outcome. Results Of all patients undergoing stage 1 of ALPPS, 12 (86%) patients were subsequently completed in stage 2 surgery. Patients who completed the ALPPS procedure showed a median overall survival (OS) of 4.2 years and a 3-year survival of 64%. Individuals without lymphatic metastases (n = 7) were all alive 1 year after surgery and if deceased, they died more than 4 years after surgery, while no patient with lymphatic metastases (n = 5) was alive 1 year after surgery. Conclusion This is the largest single-center experience of ALPPS in iCCA currently available in the literature showing excellent technical feasibility and encouraging overall survival in these patients.

KW - Intrahepatic cholangiocarcinoma (iCCA)

KW - ALPPS

KW - Oncological outcome

KW - PORTAL-VEIN LIGATION

KW - ASSOCIATING LIVER PARTITION

KW - SURGICAL-TREATMENT

KW - STAGED HEPATECTOMY

KW - PROGNOSTIC-FACTORS

KW - RISK-FACTORS

KW - DIAGNOSIS

KW - SURVIVAL

KW - RESECTIONS

KW - METASTASES

U2 - 10.1007/s00423-019-01838-2

DO - 10.1007/s00423-019-01838-2

M3 - Article

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SN - 1435-2443

VL - 404

SP - 885

EP - 894

JO - Langenbeck's Archives of Surgery

JF - Langenbeck's Archives of Surgery

IS - 7

ER -

The role of ALPPS in intrahepatic cholangiocarcinoma

Abstract

Keywords

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