ArticleTranslational cancer research2020
Application of associating liver partition and portal vein ligation for staged hepatectomy for hepatocellular carcinoma related to hepatitis B virus: comparison with traditional one-stage right hepatectomy.
Article in Translational cancer research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 7 citations in OpenAlex.
- Liver fibrosis as a predictor of liver failure and outcome following ALPPS among patients with primary liver cancer.Scientific reports · 2024Article
- Short-term efficacy of precise hepatectomy and traditional hepatectomy for primary liver cancer: a systematic review and meta-analysis.Journal of gastrointestinal oncology · 2021Article
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14 authors at 2 institutions in 1 country.
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Abstract
backgroundAssociating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been suggested to cause rapid liver hypertrophy among patients having inadequate future liver remnant (FLR). However, ALPPS is still considered as a controversial hepatocellular carcinoma (HCC) treatment, especially for those with cirrhosis. This is ascribed to the high mortality and morbidity. The present study aimed to evaluate the ALPPS safety and feasibility for HCC patients related to hepatitis B virus (HBV).
methodsThis was a retrospective observational study. Consecutive HCC cases undergoing ALPPS or RH at our hospital between September 2014 and June 2018 were included. The demographic and clinical data of patients were collected, and oncological results of ALPPS patients were compared with those receiving right hepatectomy (RH).
resultsA total of 14 ALPPS patients and 21 RH patients were consecutively collected between September 2014 and June 2018. All ALPPS patients received stage II operations, with 100% resection of R0. The median growth of FLR between operations was 48% (range, ‒0.06% to 100%) in 17 days (range, 9-30 days). 3 ALPPS patients (21.4%) suffered from severe complications (grade ≥IIIb) according to the Clavien-Dindo grade, including 1 with renal failure, and 2 with the FLR/SLV of <30% and liver failure, and 1 (4.8%) with severe complication (liver failure) after the stage I RH. Difference in the long-term survival, either overall survival (OS) or disease-free survival (DFS), between ALPPS and RH was not statistically significant.
conclusionsOur results suggest that ALPPS should be performed in highly selected patients with cirrhosis. Patients with 30%< the FLR/SLV <30% and ages <60 years old are recommended. And a longer interval time between stages is suggested to improve the safety of ALPPS. Because the long-term survival after ALPPS is similar to that after RH, which indicates that the long waiting time between stage does not increase the risk of tumor progression.
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