ArticleAnnals of surgical oncology2020
ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study.
Article in Annals of surgical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- [Cholangiocarcinoma-Intrahepatic to hilar bile duct cancer].Chirurgie (Heidelberg, Germany) · 2022Pooled it
- Imaging of mass-forming intrahepatic cholangiocarcinoma: from detection to personalized treatments.Abdominal radiology (New York) · 2026Review
- Five Advances in the Last 50 Years: Liver Malignancies.World journal of surgery · 2026Review
- Changing concepts in perihilar cholangiocarcinoma resections and surgery.International journal of surgery (London, England) · 2026Article
- Robotic Tourniquet-ALPPS: First Report of a Novel Minimally Invasive Regenerative Strategy.Annals of surgical oncology · 2026Article
- Liver hypertrophy techniques: a position paper from the Italian Group of Regenerative and Occlusive Worldwide-used techniques of hepatic Hypertrophy (I GROWtoH).Updates in surgery · 2025Article
- Perioperative and precision strategies in resectable intrahepatic cholangiocarcinoma.Global health & medicine · 2025Article
- Conversion treatment for advanced intrahepatic cholangiocarcinoma: Opportunities and challenges.World journal of gastroenterology · 2025Review
- A New Prognostic Indicator for Biliary Tract Cancers: The ABIC Score.Current oncology (Toronto, Ont.) · 2025Article
- Management of intrahepatic cholangiocarcinoma: a review for clinicians.Gastroenterology report · 2025Review
- Review
- Treatment of cholangiocarcinoma in patients with primary sclerosing cholangitis: a comprehensive review.eGastroenterology · 2024Review
- Clinical Implications of Naples Prognostic Score for Patients with Resected Cholangiocarcinoma: A Real-World Experience.Journal of inflammation research · 2024Article
- Article
- A Systematised Literature Review of Real-World Treatment Patterns and Outcomes in Unresectable Advanced or Metastatic Biliary Tract Cancer.Targeted oncology · 2023Review
- The Oncologic Implications of Tumor Multiplicity in Intrahepatic Cholangiocarcinoma: Its Prognostic Value Might Be Underestimated.Cancer research and treatment · 2023Article
- ALPPS versus portal vein embolization for hepatitis B virus-associated hepatocellular carcinoma: a delicate balance between volume and morbidity.Hepatobiliary surgery and nutrition · 2023Article
- Optimizing Growth of the Future Liver Remnant and Making In-Situ Liver Transsection Safe-A Standardized Approach to ISLT or ALPPS.Current oncology (Toronto, Ont.) · 2023Article
- Pushing the limits for the surgical treatment of intrahepatic cholangiocarcinoma.Hepatobiliary surgery and nutrition · 2023Article
- Surgical Aspects of Intrahepatic Cholangiocarcinoma.Cancers · 2022Review
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Authors and funding
55 authors at 20 institutions in 17 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundALPPS is found to increase the resectability of primary and secondary liver malignancy at the advanced stage. The aim of the study was to verify the surgical and oncological outcome of ALPPS for intrahepatic cholangiocarcinoma (ICC).
methodsThe study cohort was based on the ALPPS registry with patients from 31 international centers between August 2009 and January 2018. Propensity score matched patients receiving chemotherapy only were selected from the SEER database as controls for the survival analysis.
resultsOne hundred and two patients undergoing ALPPS were recruited, 99 completed the second stage with median inter-stage duration of 11 days. The median kinetic growth rate was 23 ml/day. R0 resection was achieved in 87 (85%). Initially high rates of morbidity and mortality decreased steadily to a 29% severe complication rate and 7% 90-day morbidity in the last 2 years. Post-hepatectomy liver failure remained the main cause of 90-day mortality. Multivariate analysis revealed insufficient future liver remnant at the stage-2 operation (FLR2) to be the only risk factor for severe complications (OR 2.91, p = 0.02). The propensity score matching analysis showed a superior overall survival in the ALPPS group compared to palliative chemotherapy (median overall survival: 26.4 months vs 14 months; 1-, 2-, and 3-year survival rates: 82.4%, 70.5% and 39.6% vs 51.2%, 21.4% and 11.3%, respectively, p < 0.01). The survival benefit, however, was not confirmed in the subgroup analysis for patients with insufficient FLR2 or multifocal ICC.
conclusionALPPS showed high efficacy in achieving R0 resections in locally advanced ICC. To get the most oncological benefit from this aggressive surgery, ALPPS would be restricted to patients with single lesions and sufficient FLR2.
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