Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO
Objective:. The objective of this study was to evaluate the long-term oncological outcomes of patients with colorectal liver metastasis (CRLM) randomized for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) or 2-stage hepatectomy (TSH). Introduction:. For advanced...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-09-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000455 |
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| author | Dennis Björk, MD Kristina Hasselgren, MD, PhD Bård I. Røsok, MD, PhD Peter N. Larsen, MD, PhD Ernesto Sparrelid, MD, PhD Gert Lindell, MD, PhD Nicolai A. Schultz, MD, PhD Bjorn A. Bjørnbeth, MD, PhD Bengt Isaksson, MD, PhD Anna Lindhoff Larsson, RN Magnus Rizell, MD, PhD Bergthor Björnsson, MD, PhD Per Sandström, MD, PhD |
| author_facet | Dennis Björk, MD Kristina Hasselgren, MD, PhD Bård I. Røsok, MD, PhD Peter N. Larsen, MD, PhD Ernesto Sparrelid, MD, PhD Gert Lindell, MD, PhD Nicolai A. Schultz, MD, PhD Bjorn A. Bjørnbeth, MD, PhD Bengt Isaksson, MD, PhD Anna Lindhoff Larsson, RN Magnus Rizell, MD, PhD Bergthor Björnsson, MD, PhD Per Sandström, MD, PhD |
| author_sort | Dennis Björk, MD |
| collection | DOAJ |
| description | Objective:. The objective of this study was to evaluate the long-term oncological outcomes of patients with colorectal liver metastasis (CRLM) randomized for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) or 2-stage hepatectomy (TSH).
Introduction:. For advanced CRLM, TSH or ALPPS may be needed for tumor freedom. The randomized, controlled, multicenter trial LIGRO showed an increased resection rate in patients who underwent ALPPS but no difference in morbidity or mortality. The 2-year survival analysis revealed better overall survival in the ALPPS group. Here, the long-term survival analysis from the LIGRO trial is reported.
Methods:. In the LIGRO trial, 100 patients were randomized to TSH or ALPPS, with the option of rescue ALPPS if insufficient growth was found after the initial step of TSH. Patients were enrolled between June 2014 and August 2016. Follow-up data for this study were collected between November 2022 and February 2023.
Results:. In total, 16 patients were alive at the end of the follow-up period. The estimated median follow-up time was 93 months. Estimated median overall survival times were 45 months in the ALPPS group and 27 months in the TSH group (P = 0.057), with 5-year survival rates of 31% and 20%, respectively. Positive prognostic factors were liver tumor-free status at the first follow-up and rectal primary tumor. Negative prognostic factors were extrahepatic disease and increasing CLRM size.
Conclusion:. Liver tumor-free status is a predictor of long-term survival, along with extrahepatic disease, large CRLM size, and rectal primary tumor. Survival did not significantly differ between patients treated with ALPPS or TSH. |
| format | Article |
| id | doaj-art-153c78a39025498ea98f3f39dd78beda |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-153c78a39025498ea98f3f39dd78beda2025-01-24T09:18:48ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-09-0153e45510.1097/AS9.0000000000000455202409000-00003Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRODennis Björk, MD0Kristina Hasselgren, MD, PhD1Bård I. Røsok, MD, PhD2Peter N. Larsen, MD, PhD3Ernesto Sparrelid, MD, PhD4Gert Lindell, MD, PhD5Nicolai A. Schultz, MD, PhD6Bjorn A. Bjørnbeth, MD, PhD7Bengt Isaksson, MD, PhD8Anna Lindhoff Larsson, RN9Magnus Rizell, MD, PhD10Bergthor Björnsson, MD, PhD11Per Sandström, MD, PhD12From the * Department of Surgery in Linköping and Institution for Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenFrom the * Department of Surgery in Linköping and Institution for Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden† Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway‡ Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark§ Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden∥ Department of Surgery, Skåne University Hospital, Lund University, Lund, Sweden‡ Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark† Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway¶ Department of Surgery, Akademiska University Hospital, Uppsala, SwedenFrom the * Department of Surgery in Linköping and Institution for Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden# Department of Transplantation and Liver Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenFrom the * Department of Surgery in Linköping and Institution for Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenFrom the * Department of Surgery in Linköping and Institution for Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenObjective:. The objective of this study was to evaluate the long-term oncological outcomes of patients with colorectal liver metastasis (CRLM) randomized for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) or 2-stage hepatectomy (TSH). Introduction:. For advanced CRLM, TSH or ALPPS may be needed for tumor freedom. The randomized, controlled, multicenter trial LIGRO showed an increased resection rate in patients who underwent ALPPS but no difference in morbidity or mortality. The 2-year survival analysis revealed better overall survival in the ALPPS group. Here, the long-term survival analysis from the LIGRO trial is reported. Methods:. In the LIGRO trial, 100 patients were randomized to TSH or ALPPS, with the option of rescue ALPPS if insufficient growth was found after the initial step of TSH. Patients were enrolled between June 2014 and August 2016. Follow-up data for this study were collected between November 2022 and February 2023. Results:. In total, 16 patients were alive at the end of the follow-up period. The estimated median follow-up time was 93 months. Estimated median overall survival times were 45 months in the ALPPS group and 27 months in the TSH group (P = 0.057), with 5-year survival rates of 31% and 20%, respectively. Positive prognostic factors were liver tumor-free status at the first follow-up and rectal primary tumor. Negative prognostic factors were extrahepatic disease and increasing CLRM size. Conclusion:. Liver tumor-free status is a predictor of long-term survival, along with extrahepatic disease, large CRLM size, and rectal primary tumor. Survival did not significantly differ between patients treated with ALPPS or TSH.http://journals.lww.com/10.1097/AS9.0000000000000455 |
| spellingShingle | Dennis Björk, MD Kristina Hasselgren, MD, PhD Bård I. Røsok, MD, PhD Peter N. Larsen, MD, PhD Ernesto Sparrelid, MD, PhD Gert Lindell, MD, PhD Nicolai A. Schultz, MD, PhD Bjorn A. Bjørnbeth, MD, PhD Bengt Isaksson, MD, PhD Anna Lindhoff Larsson, RN Magnus Rizell, MD, PhD Bergthor Björnsson, MD, PhD Per Sandström, MD, PhD Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO Annals of Surgery Open |
| title | Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO |
| title_full | Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO |
| title_fullStr | Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO |
| title_full_unstemmed | Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO |
| title_short | Long-Term Follow-Up of Patients with Advanced Colorectal Liver Metastasis: A Survival Analysis from the Randomized Controlled Multicenter Trial LIGRO |
| title_sort | long term follow up of patients with advanced colorectal liver metastasis a survival analysis from the randomized controlled multicenter trial ligro |
| url | http://journals.lww.com/10.1097/AS9.0000000000000455 |
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