Intermediate-term survival and quality of life outcomes in patients with advanced colorectal liver metastases undergoing associating liver partition and portal vein ligation for staged hepatectomy

Wanis, Kerollos Nashat; Ardiles, Victoria; Alvarez, Fernando A.; Tun-Abraham, Mauro Enrique; Linehan, David C.; Santibañés, Eduardo de; Hernandez‐Alejandro, Roberto

doi:10.1016/j.surg.2017.09.044

Cited by 47 publications

(36 citation statements)

References 40 publications

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“…Chemotherapy does not only play an important role in the neoadjuvant setting before ALPPS surgery (Figure ) but is also essential for the postoperative adjuvant treatment. This statement is supported by previous studies demonstrating that the majority of patients are embedded in a chemotherapy regimen before as well after ALPPS . Therefore, an uneventful interstage and postoperative course with fast recovery is important in case of proceeding with adjuvant or additive chemotherapy after ALPPS.…”

Section: Oncological Outcome After Alppssupporting

confidence: 67%

“…CRLM is a metastatic disease and, therefore, recurrent disease after surgical resection is not an unexpected event. Particularly hepatic recurrence after ALPPS occurs frequently in up to 65% with or without synchronous extrahepatic metastases . This figure compares with the rate of recurrence (62%) reported for conventional two‐stage hepatectomy .…”

Section: Oncological Outcome After Alppsmentioning

confidence: 67%

“…5 In our and others' opinion, situations of performing ALPPS without previous chemotherapy should be strictly avoided today. 2,14,45,[58][59][60] This statement is supported by large cohort studies demonstrating that the vast majority of patients with CRLM (89%-98%) had neoadjuvant chemotherapy before ALPPS surgery. 2,23,61 The principle of neoadjuvant therapy applies in general to the TSH approach as 98% of patients had preoperative chemotherapy in the current LIGRO trial regardless of whether ALPPS or classical TSH was performed (Table 1).…”

Section: Liver Volume and Function Of The Future Liver Remnant In Amentioning

confidence: 88%

“…The first multicenter analysis on ALPPS in patients with CRLM reported 1‐ and 2‐year OS rates of 76% and 63%, respectively (Table ) . Other following long‐term analyses on ALPPS were based on one‐ or two‐center studies with a limited number of patients reporting 3‐year survival rates ranging from 49% to 64% . A very recent preliminary and unpublished multicenter analysis of 213 patients from 9 international ALPPS centers, which was presented at the ALPPS Expert Conference at the 2018 IHPBA Meeting in Geneva, revealed 3‐ and 5‐year survival rates of 54% and 34% (Table and Figure ).…”

Section: Oncological Outcome After Alppsmentioning

confidence: 99%

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Dealing with insufficient liver remnant: Associating liver partition and portal vein ligation for staged hepatectomy

Linecker

Kuemmerli

Clavien

et al. 2019

Journal of Surgical Oncology

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Liver resection for colorectal liver metastases has emerged to highly successful treatment in the last decades. Key to this success is complete hepatic tumor removal and systemic disease control by chemotherapy. Associating liver partition and portal vein ligation for staged hepatectomy is the most recent two‐stage resection strategy for patients with very small future liver remnant making complete tumor removal possible within 1 to 2 weeks. Oncological outcome data are being collected at the moment and first results from small series reveal promising results.

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Section: Oncological Outcome After Alppssupporting

confidence: 67%

Section: Oncological Outcome After Alppsmentioning

confidence: 67%

Section: Liver Volume and Function Of The Future Liver Remnant In Amentioning

confidence: 88%

Section: Oncological Outcome After Alppsmentioning

confidence: 99%

See 2 more Smart Citations

Dealing with insufficient liver remnant: Associating liver partition and portal vein ligation for staged hepatectomy

Linecker

Kuemmerli

Clavien

et al. 2019

Journal of Surgical Oncology

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“…In a recent series from 2 high-volume centers, a 3-year overall survival of 50% was reported after 58 ALPPS for CRLM. In another admittedly small single-center analysis with 7 cases only, a 3-year survival of even 64% was reported [57, 58]. …”

mentioning

confidence: 99%

Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy in the Treatment of Colorectal Liver Metastases: Current Scenario

Lang¹,

Baumgart²,

Mittler³

2018

Dig Surg

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Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has expanded the surgical armamentarium for patients with advanced and bilateral colorectal liver metastases. However, the enthusiasm that the medical fraternity had about ALPPS was hampered by a high mortality rate and early and frequent tumor recurrence. While surgical safety has improved, mainly due to technical refinements and a better patient selection, the oncological value in the face of early tumor recurrence remains unclear. The only randomized controlled trial on ALPPS versus two-stage hepatectomy (TSH) so far confirmed that ALPPS led to higher resectability with comparable perioperative complication rate, but oncological outcome was not measured. Robust data regarding long-term outcome are still missing. TSH and ALPPS might be complementary strategies for the resection of colorectal liver metatsases (CRLM) with ALPPS being reserved for patients with no other surgical option, that is, after failed portal vein embolization or those with an extremely small future liver remnant. In other words, ALPPS can be considered a supplementary tool and a last resort in the liver surgeon’s hand to offer resectability in otherwise nonresectable CRLM. In these individual cases, and always embedded into a multimodal treatment setting, ALPPS may offer a chance of complete tumor removal and prolonged survival and even a chance for cure.

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Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

Yamamoto

Yoshida

Furuse

et al. 2020

J Hepato Biliary Pancreat

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Background Hepatectomy is standard treatment for colorectal liver metastases; however, it is unclear whether liver metastases from other primary cancers should be resected or not. The Japanese Society of Hepato‐Biliary‐Pancreatic Surgery therefore created clinical practice guidelines for the management of metastatic liver tumors. Methods Eight primary diseases were selected based on the number of hepatectomies performed for each malignancy per year. Clinical questions were structured in the population, intervention, comparison, and outcomes (PICO) format. Systematic reviews were performed, and the strength of recommendations and the level of quality of evidence for each clinical question were discussed and determined. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations. Results The eight primary sites were grouped into five categories based on suggested indications for hepatectomy and consensus of the guidelines committee. Fourteen clinical questions were devised, covering five topics: (1) diagnosis, (2) operative treatment, (3) ablation therapy, (4) the eight primary diseases, and (5) systemic therapies. The grade of recommendation was strong for one clinical question and weak for the other 13 clinical questions. The quality of the evidence was moderate for two questions, low for 10, and very low for two. A flowchart was made to summarize the outcomes of the guidelines for the indications of hepatectomy and systemic therapy. Conclusions These guidelines were developed to provide useful information based on evidence in the published literature for the clinical management of liver metastases, and they could be helpful for conducting future clinical trials to provide higher‐quality evidence.

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Intermediate-term survival and quality of life outcomes in patients with advanced colorectal liver metastases undergoing associating liver partition and portal vein ligation for staged hepatectomy

Cited by 47 publications

References 40 publications

Dealing with insufficient liver remnant: Associating liver partition and portal vein ligation for staged hepatectomy

Dealing with insufficient liver remnant: Associating liver partition and portal vein ligation for staged hepatectomy

Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy in the Treatment of Colorectal Liver Metastases: Current Scenario

Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

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