Search

Your search keyword '"Linecker, M."' showing total 9 results
Start Over Author "Linecker, M." Topic registries
9 results on '"Linecker, M."'

1. Defining Benchmark Outcomes for ALPPS.

Author

Raptis DA, Linecker M, Kambakamba P, Tschuor C, Müller PC, Hadjittofi C, Stavrou GA, Fard-Aghaie MH, Tun-Abraham M, Ardiles V, Malagó M, Campos RR, Oldhafer KJ, Hernandez-Alejandro R, de Santibañes E, Machado MA, Petrowsky H, and Clavien PA

Subjects
Adult, Aged, Benchmarking, Colorectal Neoplasms surgery, Disease-Free Survival, Female, Humans, Internationality, Ligation methods, Liver Neoplasms mortality, Liver Neoplasms surgery, Male, Middle Aged, Postoperative Complications mortality, Postoperative Complications physiopathology, Prognosis, Risk Assessment, Survival Analysis, Treatment Outcome, Colorectal Neoplasms pathology, Hepatectomy methods, Liver Neoplasms secondary, Portal Vein surgery, Registries
Abstract

Objective: The aim of this study was to use the concept of benchmarking to establish robust and standardized outcome references after the procedure ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy)., Background and Aims: The recently developed ALPPS procedure, aiming at removing primarily unresectable liver tumors, has been criticized for safety issues with high variations in the reported morbidity/mortality rates depending on patient, disease, technical characteristics, and center experience. No reference values for relevant outcome parameters are available., Methods: Among 1036 patients registered in the international ALPPS registry, 120 (12%) were benchmark cases fulfilling 4 criteria: patients ≤67 years of age, with colorectal metastases, without simultaneous abdominal procedures, and centers having performed ≥30 cases. Benchmark values, defined as the 75th percentile of the median outcome parameters of the centers, were established for 10 clinically relevant domains., Results: The benchmark values were completion of stage 2: ≥96%, postoperative liver failure (ISGLS-criteria) after stage 2: ≤5%, ICU stay after ALPPS stages 1 and 2: ≤1 and ≤2 days, respectively, interstage interval: ≤16 days, hospital stay after ALPPS stage 2: ≤10 days, rates of overall morbidity in combining both stage 1 and 2: ≤65% and for major complications (grade ≥3a): ≤38%, 90-day comprehensive complication index was ≤22, the 30-, 90-day, and 6-month mortality was ≤4%, ≤5%, and 6%, respectively, the overall 1-year, recurrence-free, liver-tumor-free, and extrahepatic disease-free survival was ≥86%, ≥50%, ≥57%, and ≥65%, respectively., Conclusions: This benchmark analysis sets key reference values for ALPPS, indicating similar outcome as other types of major hepatectomies. Benchmark cutoffs offer valid tools not only for comparisons with other procedures, but also to assess higher risk groups of patients or different indications than colorectal metastases.

Published
2019
Full Text
View/download PDF

2. Performance validation of the ALPPS risk model.

Author

Linecker M, Kuemmerli C, Kambakamba P, Schlegel A, Muiesan P, Capobianco I, Nadalin S, Torres OJ, Mehrabi A, Stavrou GA, Oldhafer KJ, Lurje G, Balci D, Lang H, Robles-Campos R, Hernandez-Alejandro R, Malago M, De Santibanes E, Clavien PA, and Petrowsky H

Subjects
Aged, Europe epidemiology, Female, Humans, Incidence, Ligation, Liver Neoplasms blood supply, Liver Neoplasms mortality, Male, Middle Aged, Retrospective Studies, Risk Factors, Hepatectomy methods, Liver Neoplasms surgery, Portal Vein surgery, Postoperative Complications epidemiology, Registries, Risk Assessment methods
Abstract

Background: Based on the International ALPPS registry, we have recently proposed two easily applicable risk models (pre-stage1 and 2) for predicting 90-day mortality in ALPPS but a validation of both models has not been performed yet., Methods: The validation cohort (VC) was composed of subsequent cases of the ALPPS registry and cases of centers outside the ALPPS registry., Results: The VC was composed of a total of 258 patients including 70 patients outside the ALPPS registry with 32 cases of early mortalities (12%). Development cohort (DC) and VC were comparable in terms of patient and surgery characteristics. The VC validated both models with an acceptable prediction for the pre-stage 1 (c-statistic 0.64, P = 0.009 vs. 0.77, P < 0.001) and a good prediction for the pre-stage 2 model (c-statistic 0.77, P < 0.001 vs. 0.85, P < 0.001) as compared to the DC. Overall model performance measured by Brier score was comparable between VC and DC for the pre-stage 1 (0.089 vs. 0.081) and pre-stage 2 model (0.079 vs. 0087)., Conclusion: The ALPPS risk score is a fully validated model to estimate the individual risk of patients undergoing ALPPS and to assist clinical decision making to avoid procedure-related early mortality after ALPPS., (Copyright © 2018 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)

Published
2019
Full Text
View/download PDF

3. Indicating ALPPS for Colorectal Liver Metastases: A Critical Analysis of Patients in the International ALPPS Registry.

Author

Schnitzbauer AA, Schadde E, Linecker M, Machado MA, Adam R, Malago M, Clavien PA, de Santibanes E, and Bechstein WO

Subjects
Aged, Body Mass Index, Colorectal Neoplasms mortality, Colorectal Neoplasms surgery, Female, Humans, Ligation, Liver Neoplasms mortality, Male, Middle Aged, Neoplasm Staging, Organ Size, Patient Selection, Survival Rate, Treatment Outcome, Colorectal Neoplasms pathology, Hepatectomy, Liver Neoplasms secondary, Liver Neoplasms surgery, Portal Vein surgery, Registries
Abstract

Objectives: In the international associating liver partition and portal vein ligation for staged hepatectomy registry, more than 50% of patients underwent associating liver partition and portal vein ligation for staged hepatectomy with a right hepatectomy. This study evaluated the necessity of two-stage hepatectomies being performed as right hepatectomy associating liver partition and portal vein ligation for staged hepatectomy in patients with colorectal liver metastases versus right trisectionectomy associating liver partition and portal vein ligation for staged hepatectomy., Patients and Methods: All patients registered between 2012 and 2017 undergoing associating liver partition and portal vein ligation for staged hepatectomy for colorectal liver metastases were included. A liver to body weight index of 0.5 or less prior to stage I in the presence of liver damage was used as an internationally accepted standard to justify a two-stage hepatectomy., Results: Four-hundred and three patients with colorectal liver metastases with right hepatectomy associating liver partition and portal vein ligation for staged hepatectomy (n = 183) or right trisectionectomy associating liver partition and portal vein ligation for staged hepatectomy (n = 220) were analyzed. Presence of metastases in segments II/III, liver damage, number of patients on chemotherapy, and cycles were comparable, and there was a comparable response to chemotherapy. Liver to body weight index was different prior to stage 1 (right trisectionectomy associating liver partition and portal vein ligation for staged hepatectomy: 0.33 ± 0.12 versus right hepatectomy associating liver partition and portal vein ligation for staged hepatectomy: 0.40 ± 0,14; P < .001) and prior to stage 2 (right trisectionectomy associating liver partition and portal vein ligation for staged hepatectomy: 0.58 ± 0.17 versus right hepatectomy associating liver partition and portal vein ligation for staged hepatectomy: 0.66 ± 0,18; P < .001). Hypertrophy rates were similar between groups. As much as 16.9% and 7.2% of patients in right hepatectomy associating liver partition and portal vein ligation for staged hepatectomy and right trisectionectomy associating liver partition and portal vein ligation for staged hepatectomy had no apparent justification for a two-stage hepatectomy based on LBWI prior to stage 1 and absence of chemotherapy (<12 cycles)., Conclusion: More than 15% of associating liver partition and portal vein ligation for staged hepatectomy procedures were performed in patients who may have had no indication for a two-stage hepatectomy, especially in the group of patients with right hepatectomy. Thus, it appears that there is a risk of the overuse of associating liver partition and portal vein ligation for staged hepatectomy because of its great potential to induce volume growth. Due to the high perioperative risk of associating liver partition and portal vein ligation for staged hepatectomy, indications should be carefully reconsidered., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Published
2018
Full Text
View/download PDF

4. Survival after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for advanced colorectal liver metastases: A case-matched comparison with palliative systemic therapy.

Author

Olthof PB, Huiskens J, Wicherts DA, Huespe PE, Ardiles V, Robles-Campos R, Adam R, Linecker M, Clavien PA, Koopman M, Verhoef C, Punt CJ, van Gulik TM, and de Santibanes E

Subjects
Aged, Case-Control Studies, Colorectal Neoplasms mortality, Colorectal Neoplasms surgery, Disease-Free Survival, Female, Hepatectomy mortality, Humans, Ligation methods, Liver Neoplasms mortality, Male, Middle Aged, Neoplasm Invasiveness pathology, Neoplasm Staging, Patient Selection, Portal Vein surgery, Prognosis, Risk Assessment, Survival Analysis, Treatment Outcome, Colorectal Neoplasms pathology, Hepatectomy methods, Liver Neoplasms secondary, Liver Neoplasms surgery, Palliative Care methods, Registries
Abstract

Background: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows the resection of colorectal liver metastases with curative intent which would otherwise be unresectable and only eligible for palliative systemic therapy. This study aimed to compare outcomes of ALPPS in patients with otherwise unresectable colorectal liver metastases with matched historic controls treated with palliative systemic treatment., Methods: All patients with colorectal liver metastases from the international ALPPS registry were identified and analyzed. Survival data were compared according to the extent of disease. Otherwise unresectable ALPPS patients were defined by at least 2 of the following criteria: ≥6 metastasis, ≥2 future remnant liver metastasis, ≥6 involved segments excluding segment 1. These patients were matched with patients included in 2, phase 3, metastatic, colorectal cancer trials (CAIRO and CAIRO2) using propensity scoring in order to compare survival., Results: Of 295 patients with colorectal liver metastases in the ALPPS registry, 70 patients had otherwise unresectable disease defined by the proposed criteria. Two-year overall survival was 49% and 72% for patients with ≥2 and <2 criteria, respectively (P = .002). Median disease-free survival was 6 months compared to 12 months (P < .001) in the ≥2 and <2 criteria groups, respectively. Median overall survival was comparable between ALPPS patients with ≥2 criteria and case-matched patients who received palliative treatment (24.0 vs 17.6 months, P = .088)., Conclusion: Early oncologic outcomes of patients with advanced liver metastases undergoing ALPPS were not superior to results of matched patients receiving systemic treatment with palliative intent. Careful patient selection is essential in order to improve outcomes., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Published
2017
Full Text
View/download PDF

5. Liver growth prediction in ALPPS - A multicenter analysis from the international ALPPS registry

Author

Victor Lopez‐Lopez, Michael Linecker, Juan Cruz, Roberto Brusadin, Asuncion Lopez‐Conesa, Marcel Autran Machado, Roberto Hernandez‐Alejandro, Alejandro Sergey Voskanyan, Jun Li, Deniz Balci, René Adam, Victoria Ardiles, Eduardo De Santibañes, Federico Tomassini, Roberto I. Troisi, Georg Lurje, Stéphanie Truant, Francois‐René Pruvot, Bergthor Björnsson, Miroslav Stojanovic, Roberto Montalti, Valentin Cayuela, Ivan Kozyrin, Xiujun Cai, Emilio de Vicente, Falk Rauchfuss, Peter Lodge, Francesca Ratti, Luca Aldrighetti, Karl J. Oldhafer, Massimo Malago, Henrik Petrowsky, Pierre‐Alain Clavien, Ricardo Robles‐Campos, Lopez-Lopez, Victor, Linecker, Michael, Cruz, Juan, Brusadin, Roberto, Lopez-Conesa, Asuncion, Machado, Marcel Autran, Hernandez-Alejandro, Roberto, Voskanyan, Alejandro Sergey, Li, Jun, Balci, Deniz, Adam, René, Ardiles, Victoria, De Santibañes, Eduardo, Tomassini, Federico, Troisi, Roberto I, Lurje, Georg, Truant, Stéphanie, Pruvot, Francois-René, Björnsson, Bergthor, Stojanovic, Miroslav, Montalti, Roberto, Cayuela, Valentin, Kozyrin, Ivan, Cai, Xiujun, de Vicente, Emilio, Rauchfuss, Falk, Lodge, Peter, Ratti, Francesca, Aldrighetti, Luca, Oldhafer, Karl J, Malago, Massimo, Petrowsky, Henrik, Clavien, Pierre-Alain, Robles-Campos, Ricardo, Lopez-Lopez, V., Linecker, M., Cruz, J., Brusadin, R., Lopez-Conesa, A., Machado, M. A., Hernandez-Alejandro, R., Voskanyan, A. S., Li, J., Balci, D., Adam, R., Ardiles, V., De Santibanes, E., Tomassini, F., Troisi, R. I., Lurje, G., Truant, S., Pruvot, F. -R., Bjornsson, B., Stojanovic, M., Montalti, R., Cayuela, V., Kozyrin, I., Cai, X., de Vicente, E., Rauchfuss, F., Lodge, P., Ratti, F., Aldrighetti, L., Oldhafer, K. J., Malago, M., Petrowsky, H., Clavien, P. -A., and Robles-Campos, R.

Subjects
Male, Hepatology, rapid hypertrophy, Portal Vein, Liver Neoplasms, Hypertrophy, Cohort Studies, liver cancer, Humans, Hepatectomy, anthropometrics, Female, Registries, ALPPS, anthropometric, liver regeneration, Ligation
Abstract

Background: While ALPPS triggers a fast liver hypertrophy, it is still unclear which factors matter most to achieve accelerated hypertrophy within a short period of time. The aim of the study was to identify patient-intrinsic factors related to the growth of the future liver remnant (FLR). Methods: This cohort study is composed of data derived from the International ALPPS Registry from November 2011 and October 2018. We analyse the influence of demographic, tumour type and perioperative data on the growth of the FLR. The volume of the FLR was calculated in millilitre and percentage using computed-tomography (CT) scans before and after stage 1, both according to Vauthey formula. Results: A total of 734 patients were included from 99 centres. The median sFLR at stage 1 and stage 2 was 0.23 (IQR, 0.18–0.28) and 0.39 (IQR: 0.31–0.46), respectively. The variables associated with a lower increase from sFLR1 to sFLR2 were age˃68 years (p =.02), height ˃1.76 m (p ˂.01), weight ˃83 kg (p ˂.01), BMI˃28 (p ˂.01), male gender (p ˂.01), antihypertensive therapy (p ˂.01), operation time ˃370 minutes (p ˂.01) and hospital stay˃14 days (p ˂.01). The time required to reach sufficient volume for stage 2, male gender accounts 40.3% in group ˂7 days, compared with 50% of female, and female present 15.3% in group ˃14 days compared with 20.6% of male. Conclusions: Height, weight, FLR size and gender could be the variables that most constantly influence both daily growths, the interstage increase and the standardized FLR before the second stage.

Published
2022

6. First Long-term Oncologic Results of the ALPPS Procedure in a Large Cohort of Patients With Colorectal Liver Metastases

Author

Carlos Castro-Benitez, Roberto Brusadin, Jun Li, Martin Teutsch, Luca Aldrighetti, Patryk Kambakamba, Jan Bednarsch, Arianeb Mehrabi, Mauro E Tun Abraham, Marcus N. Scherer, François-René Pruvot, Roberto Hernandez-Alejandro, Eduardo Fernandes, Christoph Kuemmerli, Emir Hoti, Onur Elvan Kirimker, Federico Tomassini, Tim Reese, Francesca Ratti, Pim B. Olthof, Stéphanie Truant, Ivan Capobianco, Roberto Troisi, Mohammad-Hossein Fard-Aghaie, Henrik Petrowsky, Victor Lopez-Lopez, Philipp Kron, Pierre-Alain Clavien, Hans J. Schlitt, Ricardo Robles-Campos, Omid Ghamarnejad, Silvio Nadalin, Thomas M. van Gulik, René Adam, Deniz Balci, Marcel Autran C. Machado, Peter Lodge, Ralph Fritsch, Dimitri A. Raptis, Sergey Voskanyan, Georg Lurje, Karl J. Oldhafer, Massimo Malagó, Michael Linecker, Eduardo de Santibañes, Victoria Ardiles, Petrowsky, H., Linecker, M., Raptis, D. A., Kuemmerli, C., Fritsch, R., Kirimker, O. E., Balci, D., Ratti, F., Aldrighetti, L., Voskanyan, S., Tomassini, F., Troisi, R., Bednarsch, J., Lurje, G., Fard-Aghaie, M. -H., Reese, T., Oldhafer, K. J., Ghamarnejad, O., Mehrabi, A., Abraham, M. E. T., Truant, S., Pruvot, F. -R., Hoti, E., Kambakamba, P., Capobianco, I., Nadalin, S., Fernandes, E. S. M., Kron, P., Lodge, P., Olthof, P. B., van Gulik, T., Castro-Benitez, C., Adam, R., Machado, M. A., Teutsch, M., Li, J., Scherer, M. N., Schlitt, H. J., Ardiles, V., de Santibanes, E., Brusadin, R., Lopez-Lopez, V., Robles-Campos, R., Malago, M., Hernandez-Alejandro, R., and Clavien, P. -A.

Subjects
Male, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, law.invention, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, law, Risk Factors, medicine, Hepatectomy, Humans, Registries, Survival analysis, Aged, business.industry, Liver Neoplasms, Perioperative, Middle Aged, Survival Analysis, Confidence interval, Surgery, Response Evaluation Criteria in Solid Tumors, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, Female, business, Colorectal Neoplasms
Abstract

Objectives: To analyze long-term oncological outcome along with prognostic risk factors in a large cohort of patients with colorectal liver metastases (CRLM) undergoing ALPPS. Background: ALPPS is a two-stage hepatectomy variant that increases resection rates and R0 resection rates in patients with primarily unresectable CRLM as evidenced in a recent randomized controlled trial. Long-term oncologic results, however, are lacking. Methods: Cases in- and outside the International ALPPS Registry were collected and completed by direct contacts to ALPPS centers to secure a comprehensive cohort. Overall, cancer-specific (CSS), and recurrence-free (RFS) survivals were analyzed along with independent risk factors using Cox-regression analysis. Results: The cohort included 510 patients from 22 ALPPS centers over a 10-year period. Ninety-day mortality was 4.9% and median overall survival, CSS, and RFS were 39, 42, and 15 months, respectively. The median follow-up time was 38 months (95% confidence interval 32-43 months). Multivariate analysis identified tumor-characteristics (primary T4, right colon), biological features (K/N-RAS status), and response to chemotherapy (Response Evaluation Criteria in Solid Tumors) as independent predictors of CSS. Traditional factors such as size of metastases, uni versus bilobar involvement, and liver-first approach were not predictive. When hepatic recurrences after ALPPS was amenable to surgical/ablative treatment, median CSS was significantly superior compared to chemotherapy alone (56 vs 30 months, P < 0.001). Conclusions: This large cohort provides the first evidence that patients with primarily unresectable CRLM treated by ALPPS have not only low perioperative mortality, but achieve appealing long-term oncologic outcome especially those with favorable tumor biology and good response to chemotherapy.

Published
2020

7. ALPPS in neuroendocrine liver metastases not amenable for conventional resection – lessons learned from an interim analysis of the international ALPPS registry

Author

Ivan Kozyrin, Pierre-Alain Clavien, Jee K Low, Nadja Lehwald-Tywuschik, Francesca Ratti, Massimo Malagó, François-René Pruvot, Henrik Petrowsky, Emilio Vicente, Luca Aldrighetti, Wolfram T. Knoefel, Michail Pizanias, Patryk Kambakamba, Valentina Ferrri, Michael Linecker, Deniz Balci, Ashley K Clift, Ricardo Robles-Campos, Victoria Ardiles, Basant Mahadevappa, Andrea Frilling, Andreas Prachalias, Stéphanie Truant, Sergey Voskanyan, Dimitri A. Raptis, Eduardo de Santibañes, Karl J. Oldhafer, Gregor A. Stavrou, University of Zurich, Frilling, Andrea, Linecker, M., Kambakamba, P., Raptis, D. A., Malago, M., Ratti, F., Aldrighetti, L., Robles-Campos, R., Lehwald-Tywuschik, N., Knoefel, W. T., Balci, D., Ardiles, V., De Santibanes, E., Truant, S., Pruvot, F. -R., Stavrou, G. A., Oldhafer, K. J., Voskanyan, S., Mahadevappa, B., Kozyrin, I., Low, J. K., Ferrri, V., Vicente, E., Prachalias, A., Pizanias, M., Clift, A. K., Petrowsky, H., Clavien, P. -A., and Frilling, A.

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, 610 Medicine & health, 030230 surgery, Resection, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Overall survival, Hepatectomy, Humans, Medicine, Effective treatment, 2715 Gastroenterology, Registries, Stage (cooking), Ligation, Retrospective Studies, R0 resection, 10217 Clinic for Visceral and Transplantation Surgery, Hepatology, Portal Vein, business.industry, Patient Selection, Liver Neoplasms, Gastroenterology, Middle Aged, Interim analysis, Carcinoma, Neuroendocrine, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Female, 2721 Hepatology, business
Abstract

Background Surgery is the most effective treatment option for neuroendocrine liver metastases (NELM). This study investigated the role of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) as a novel strategy in treatment of NELM. Methods The International ALPPS Registry was reviewed to study patients who underwent ALPPS for NELM. Results From 2010 to 2017, 954 ALPPS procedures from 135 international centers were recorded in the International ALPPS Registry. Of them, 24 (2.5%) were performed for NELM. Twenty-one patients entered the final analysis. Overall grade ≥3b morbidity was 9% after stage 1 and 27% after stage 2. Ninety-day mortality was 5%. R0 resection was achieved in 19 cases (90%) at stage 2. Median follow-up was 28 (19–48) months. Median disease free survival (DFS) was 17.3 (95% CI: 7.1–27.4) months, 1-year and 2-year DFS was 73.2% and 41.8%, respectively. Median overall survival (OS) was not reached. One-year and 2-year OS was 95.2% and 95.2%, respectively. Conclusions ALPPS appears to be a suitable strategy for inclusion in the multimodal armamentarium of well-selected patients with neuroendocrine liver metastases. In light of the morbidity in this initial series and a high rate of disease-recurrence, the procedure should be taken with caution.

Published
2020

8. ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study

Author

Ulf P. Neumann, J. Baumgart, Athanasios Petrou, Utz Settmacher, Sergey Voskanyan, M. Moustafa, Carlos Castro-Benitez, Roberto Montalti, Chao Liu, René Adam, Hans J. Schlitt, Ricardo Robles-Campos, Emilio Vicente, Yuji Soejima, E. Fasolo, Umberto Cillo, Jakub Kristek, Ivan Capobianco, Federico Tomassini, Roberto Hernandez-Alejandro, Asmus Heumann, Jakob R. Izbicki, Natascha Nuessler, Hauke Lang, Oszkár Hahn, Alexandros Kantas, Michael R. Schön, Roberto Troisi, Massimo Malagó, Silvio Nadalin, Georg Lurje, Stefan A. Topp, Michael Linecker, Enrico Gringeri, Francesca Ratti, Victoria Ardiles, Karl J. Oldhafer, Björn-Ole Stüben, Christiane Bruns, Luca Aldrighetti, Stefan M. Brunner, Henrik Petrowsky, Jun Li, Deniz Balci, Jens Rolinger, Andreas A. Schnitzbauer, Roger Wahba, Jan Bednarsch, Marco Vivarelli, Eduardo Fernandes, Pierre-Alain Clavien, Falk Rauchfuss, Jiri Fronek, Eduardo de Santibañes, Bergthor Björnsson, Li, J., Moustafa, M., Linecker, M., Lurje, G., Capobianco, I., Baumgart, J., Ratti, F., Rauchfuss, F., Balci, D., Fernandes, E., Montalti, R., Robles-Campos, R., Bjornsson, B., Topp, S. A., Fronek, J., Liu, C., Wahba, R., Bruns, C., Brunner, S. M., Schlitt, H. J., Heumann, A., Stuben, B. -O., Izbicki, J. R., Bednarsch, J., Gringeri, E., Fasolo, E., Rolinger, J., Kristek, J., Hernandez-Alejandro, R., Schnitzbauer, A., Nuessler, N., Schon, M. R., Voskanyan, S., Petrou, A. S., Hahn, O., Soejima, Y., Vicente, E., Castro-Benitez, C., Adam, R., Tomassini, F., Troisi, R. I., Kantas, A., Oldhafer, K. J., Ardiles, V., de Santibanes, E., Malago, M., Clavien, P. -A., Vivarelli, M., Settmacher, U., Aldrighetti, L., Neumann, U., Petrowsky, H., Cillo, U., Lang, H., and Nadalin, S.

Subjects
Adult, Male, medicine.medical_specialty, International Cooperation, Subgroup analysis, Antineoplastic Agents, Postoperative Hemorrhage, Malignancy, Cholangiocarcinoma, Postoperative Complications, medicine, Hepatectomy, Humans, Surgical Wound Infection, Registries, ddc:610, Stage (cooking), Risk factor, Propensity Score, Ligation, Intrahepatic Cholangiocarcinoma, Survival analysis, Aged, Proportional Hazards Models, Aged, 80 and over, business.industry, Portal Vein, Kirurgi, Palliative Care, Ascites, Middle Aged, medicine.disease, Surgery, Survival Rate, Bile Ducts, Intrahepatic, Treatment Outcome, Oncology, Bile Duct Neoplasms, Hepatobiliary Tumors, Propensity score matching, Cohort, Female, business, Liver Failure, SEER Program
Abstract

Annals of surgical oncology (2020). doi:10.1245/s10434-019-08192-z, Published by Springer, Berlin [u.a.]

Published
2020

9. Variation in complications and mortality following ALPPS at early-adopting centers

Author

Wolfram T. Knoefel, Rafaela Capelli, Roberto Hernandez-Alejandro, Marcel Cerqueira César Machado, Philip C. Müller, Oleg G Skipenko, Francesca Ratti, Valentina Ferri, Michael Linecker, Koji Tomiyama, Victoria Ardiles, Karl J. Oldhafer, Roberto Brusadin, Luca Aldrighetti, Oszkár Hahn, Natascha Nüssler, Kerollos Nashat Wanis, Nikita Chardarov, Ricardo Robles-Campos, Elio Jovine, Marcelo Enne, Matteo Serenari, Martin de Santibañes, Tim Reese, Sergey Voskanyan, Alexey S. Zhurbin, Georg Lurje, Emilio Vicente, René Adam, Arin L. Madenci, Yuki Kitano, Nadja Lehwald, Wanis, K. N., Linecker, M., Madenci, A. L., Muller, P. C., Nussler, N., Brusadin, R., Robles-Campos, R., Hahn, O., Serenari, M., Jovine, E., Lehwald, N., Knoefel, W. T., Reese, T., Oldhafer, K., de Santibanes, M., Ardiles, V., Lurje, G., Capelli, R., Enne, M., Ratti, F., Aldrighetti, L., Zhurbin, A. S., Voskanyan, S., Machado, M., Kitano, Y., Adam, R., Chardarov, N., Skipenko, O., Ferri, V., Vicente, E., Tomiyama, K., and Hernandez-Alejandro, R.

Subjects
Pediatrics, medicine.medical_specialty, Hepatology, business.industry, Portal Vein, Liver Neoplasms, Gastroenterology, Perioperative, 030230 surgery, Lower risk, Article, Center volume, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Treatment Outcome, 030220 oncology & carcinogenesis, medicine, Hepatectomy, Humans, Registries, business, Complication, Ligation
Abstract

Background Various, often conflicting, estimates for post-operative morbidity and mortality following ALPPS have been reported in the literature, suggesting that considerable center-level variation exists. Some of this variation may be related to center volume and experience. Methods Using data from seventeen centers who were early adopters of the ALPPS technique, we estimated the variation, by center, in standardized 90-day mortality and comprehensive complication index (CCI) for patients treated between 2012 and 2018. Results We estimated that center-specific 90-day mortality following treatment with ALPPS varied from 4.2% (95% CI: 0.8, 9.9) to 29.1% (95% CI: 13.9, 50.9), and that center-specific CCI following treatment with ALPPS varied from 17.0 (95% CI: 7.5, 26.5) to 49.8 (95% CI: 38.1, 61.8). Declines in estimated 90-day mortality and CCI were observed over time, and almost all individual centers followed this trend. Patients treated at centers with a higher number of ALPPS cases performed over the prior year had a lower risk of post-operative mortality. Conclusion Despite considerable center-level variation in ALPPS outcomes, perioperative outcomes following ALPPS have improved over time and treatment at higher volume centers results in a lower risk of 90-day mortality. Morbidity and mortality remain concerningly high at some centers.

Published
2019

Catalog

Books, media, physical & digital resources
See catalog results