Long-term outcome after conventional two-stage hepatectomy versus tourniquet-ALPPS in colorectal liver metastases: A propensity score matching analysis Journal Article

  

Authors:	Robles-Campos, R.; Brusadin, R.; López-Conesa, A.; López-López, V.; Navarro-Barrios, Á; López-Espín, J. J.; Arévalo-Pérez, J.; Parrilla, P.
Article Title:	Long-term outcome after conventional two-stage hepatectomy versus tourniquet-ALPPS in colorectal liver metastases: A propensity score matching analysis
Abstract:	Background: To compare the overall survival (OS) and disease-free survival (DFS) of Tourniquet-ALPPS (T-ALPPS) and conventional two-stage hepatectomy (TSH) in patients with colorectal liver metastases (CRLM). Methods: A retrospective study from a prospectively collected database was performed between October 2000 and July 2016. TSH was performed before September 2011, after which time T-ALPPS became the technique of choice. A propensity score matching (PSM) was performed based on a 1:1 ratio with consideration of the following variables: number and size of metastases, bilobar disease presence, and chemotherapy received. Results: Thirty-four patients received T-ALPPS; 41 patients received TSH. After PSM, 21 patients remained in each group, with 100% resectability in the T-ALPPS group and 90.5% resectability in the TSH group. The median OS for TSH was 41 months; for T-ALPPS, the median OS was 36 months (P = 0.925). The median DFS was 16 months in the TSH group; the median DFS was 9 months in the T-ALPPS group (P = 0.930). The 1-, 3-, and 5-year OS for TSH was 81%, 66.7%, and 23.8% vs. 76.2%, 57.1%, and 22.9% for T-ALPPS, respectively. The 1-, 3-, and 5-year DFS for TSH was 66.7%, 9.5%, and 5% vs. 44.6%, 11.1%, and 11.1% for T-ALPPS, respectively. The volume increase with T-ALPPS was superior to that with TSH (68% vs. 39%; P = 0.018). There were no differences in morbidity and mortality after stages 1 and 2. Conclusions: T-ALPPS produces a similar outcome to TSH, indicating that it could be a safe and effective alternative for curative hepatectomy for all patients. © 2019, Société Internationale de Chirurgie.
Journal Title:	World Journal of Surgery
Volume:	43
Issue:	9
ISSN:	0364-2313
Publisher:	Springer
Date Published:	2019-09-01
Start Page:	2281
End Page:	2289
Language:	English
DOI:	10.1007/s00268-019-05031-w
PUBMED:	31119359
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85066915979&doi=10.1007%2fs00268-019-05031-w&partnerID=40&md5=2d97ebb662859f9cb0606d2076c127a3
Notes:	Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/151207