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Should ALPPS be Use...
Should ALPPS be Used for Liver Resection in Intermediate-Stage HCC?
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- DHaese, J. G. (författare)
- Hospital University of Munich, Germany
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- Neumann, J. (författare)
- University of Munich, Germany
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- Weniger, M. (författare)
- Hospital University of Munich, Germany
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- Pratschke, S. (författare)
- Hospital University of Munich, Germany
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- Björnsson, Bergthor (författare)
- Linköpings universitet,Avdelningen för kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US
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- Ardiles, V. (författare)
- Italian Hospital Buenos Aires, Argentina
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- Chapman, W. (författare)
- Washington University, MO 63110 USA
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- Hernandez-Alejandro, R. (författare)
- University of Western Ontario, Canada
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- Soubrane, O. (författare)
- Beaujon Hospital, France
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- Robles-Campos, R. (författare)
- Virgen de la Arrixaca University Hospital, Spain
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- Stojanovic, M. (författare)
- University of Clin Centre, Serbia
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- Dalla Valle, R. (författare)
- Parma University Hospital, Italy
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- Chan, A. C. Y. (författare)
- University of Hong Kong, Peoples R China
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- Coenen, M. (författare)
- University of Munich, Germany
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- Guba, M. (författare)
- Hospital University of Munich, Germany
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- Werner, J. (författare)
- Hospital University of Munich, Germany
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- Schadde, E. (författare)
- University of Zurich, Switzerland
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- Angele, M. K. (författare)
- Hospital University of Munich, Germany
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(creator_code:org_t)
- 2015-12-08
- 2016
- Engelska.
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Ingår i: Annals of Surgical Oncology. - : SPRINGER. - 1068-9265 .- 1534-4681. ; 23:4, s. 1335-1343
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Extended liver resections in patients with hepatocellular carcinoma (HCC) are problematic due to hepatitis, fibrosis, and cirrhosis. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) has been promoted as a novel method to induce hypertrophy for patients with extensive colorectal liver metastases, but outcomes in HCC have not been well investigated. All patients registered in the international ALPPS Registry (http://www.alpps.org) from 2010 to 2015 were studied. Hypertrophy of the future liver remnant, perioperative morbidity and mortality, age, overall survival, and other parameters were compared between patients with HCC and patients with colorectal liver metastases (CRLM). The study compared 35 patients with HCC and 225 patients with CRLM. The majority of patients undergoing ALPPS for HCC fall into the intermediate-stage category of the Barcelona clinic algorithm. In this study, hypertrophy was rapid and extensive for the HCC patients, albeit lower than for the CRLM patients (47 vs. 76 %; p < 0.002). Hypertrophy showed a linear negative correlation with the degrees of fibrosis. The 90-day mortality for ALPPS used to treat HCC was almost fivefold higher than for CRLM (31 vs. 7 %; p < 0.001). Multivariate analysis showed that patients older than 61 years had a significantly reduced overall survival (p < 0.004). The ALPPS approach induces a considerable hypertrophic response in HCC patients and allows resection of intermediate-stage HCC, albeit at the cost of a 31 % perioperative mortality rate. The use of ALPPS for HCC remains prohibitive for most patients and should be performed only for a highly selected patient population younger than 60 years with low-grade fibrosis.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
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- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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DHaese, J. G.
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Neumann, J.
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Weniger, M.
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Pratschke, S.
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Björnsson, Bergt ...
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Ardiles, V.
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visa fler...
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Chapman, W.
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Hernandez-Alejan ...
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Soubrane, O.
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Robles-Campos, R ...
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Stojanovic, M.
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Dalla Valle, R.
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Chan, A. C. Y.
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Coenen, M.
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Guba, M.
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Werner, J.
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Schadde, E.
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Angele, M. K.
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
- Artiklar i publikationen
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Annals of Surgic ...
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Linköpings universitet