ArticleWorld journal of surgery2017
Patient Survival After Simultaneous ALPPS and Colorectal Resection.
Article in World journal of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Simultaneous resection of synchronous colorectal liver metastases: a promising alternative to staged resections.Hepatobiliary surgery and nutrition · 2021Article
- Associating liver partition and portal vein ligation for staged hepatectomy in the treatment of colorectal cancer liver metastases.World journal of gastrointestinal surgery · 2021Review
- The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology.Updates in surgery · 2021Article
- Article
- Hypertrophy and Liver Function in ALPPS: Correlation with Morbidity and Mortality.Visceral medicine · 2017Review
- Two cases of ALPPS procedure: simultaneous ALPPS and colorectal resection and ALPPS procedure for hepatic malignancy larger than 15 centimeter.Annals of hepato-biliary-pancreatic surgery · 2017Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiver resection combined with colorectal surgery (CRS) is the only curative option in many patients presenting with synchronous colorectal cancer and liver metastases (CRLM). Simultaneous resection has been shown to offer benefits in patients with low hepatic tumor load; however, in the setting of in situ colorectal tumor with extensive CRLM and a small predicted future liver remnant (FLR), the use of simultaneous ALPPS and CRS is controversial, lacking outcome data.
methodsThirty-one cases of simultaneous ALPPS and CRS prospectively entered into the International ALPPS Registry were examined. Univariate analysis was used to identify factors associated with 90-day mortality after stage-2.
resultsThirty patients (97%) completed both stages. CRS was performed during stage-1 in 22 patients (73%). Seven patients (23%) had severe complications (Clavien-Dindo ≥ IIIb) following stage-2 ALPPS. The 90-day mortality rate was 15%. Patients who had a severe complication after stage-1 were significantly more likely to have 90-day mortality following stage-2 (p = 0.002). MELD score > 10 on postoperative day-5 after stage-1 was also significantly associated with 90-day mortality (p = 0.011). Disease-free survival and overall survival were 36% and 76% at 1 year, respectively.
conclusionsIn light of the high mortality and poor long-term survival identified in this series, the adoption of ALPPS with CRS cannot be recommended without further data. Patients who suffer severe complications or have an elevated MELD score after stage-1 are at higher risk of mortality following stage-2.
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