Jan Bednarsch1, Zoltan Czigany1, Isabella Lurje1, Pavel Strnad2, Philipp Bruners3, Tom Florian Ulmer1, Marcel den Dulk1,4, Georg Lurje5, Ulf Peter Neumann1,4. 1. Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. 2. Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany. 3. Department of Radiology, University Hospital RWTH Aachen, Aachen, Germany. 4. Department of Surgery, Maastricht University Medical Centre (MUMC), Maastricht, Netherlands. 5. Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. glurje@ukaachen.de.
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.
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.
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Authors: Jan Bednarsch; Zoltan Czigany; Samara Sharmeen; Gregory van der Kroft; Pavel Strnad; Tom Florian Ulmer; Peter Isfort; Philipp Bruners; Georg Lurje; Ulf Peter Neumann Journal: World J Surg Oncol Date: 2020-06-24 Impact factor: 2.754
Authors: Sandra Pavicevic; Sophie Reichelt; Deniz Uluk; Isabella Lurje; Cornelius Engelmann; Dominik P Modest; Uwe Pelzer; Felix Krenzien; Nathanael Raschzok; Christian Benzing; Igor M Sauer; Sebastian Stintzing; Frank Tacke; Wenzel Schöning; Moritz Schmelzle; Johann Pratschke; Georg Lurje Journal: Cancers (Basel) Date: 2022-02-17 Impact factor: 6.639
Authors: Isabella Lurje; Zoltan Czigany; Sarah Eischet; Jan Bednarsch; Tom Florian Ulmer; Peter Isfort; Pavel Strnad; Christian Trautwein; Frank Tacke; Ulf Peter Neumann; Georg Lurje Journal: Hepatol Commun Date: 2022-05-26