Variables | ALPPS vs. TSH/PVE analysis | ||
---|---|---|---|
ALPPS (n = 21) | TSH/PVE (n = 37) | p value | |
Operative data step 1 | |||
Operative time step 1 (minutes) | 270 (215–303) | 195 (145–250) | .001 |
Operative procedure step 1, n (%) | n.a. | ||
Left atypical | 0 | 23 (62) | |
Left lateral resection | 0 | 7 (19) | |
Right atypical | 0 | 2 (5) | |
Right posterior resection | 0 | 1 (3) | |
Right hepatectomy | 6 (29) | 2 (5) | |
Right hepatectomy plus atypical left | 4 (19) | 0 | |
Right hepatectomy plus left lateral resection | 1 (5) | 0 | |
Extended right hepatectomy | 3 (14) | 0 | |
Extended right plus atypical left | 2 (10) | 0 | |
Right trisectionectomy | 4 (19) | 0 | |
Right trisectionectomy plus atypical left | 1 (5) | 0 | |
Others | 0 | 2 (5) | |
Intraoperative blood transfusion step 1 (y/n) | 7 (33)/14 (67) | 6 (16)/31 (84) | .133 |
Inter-stage data | |||
Time interval between the stages (days) | 10 (8–14) | 57 (34–113) | < .001 |
Inter-stage chemotherapy (y/n) | 0 | 9 (24) | .014 |
Inter-stage PVE (y/n) | 0 | 27 (73) | < .001 |
Rate of completion, n (%) | 20 (95) | 34 (92) | .629 |
Reason for non-completion, n (%) | .323 | ||
Insufficient hypertrophy | 1 (100) | 2 (67) | |
Progressive disease | 0 | 1 (33) | |
Operative data step 2 | |||
Operative time step 2 (minutes) | 123 (94–170) | 280 (240–319) | < .001 |
Operative procedure step 2, n (%) | |||
ALPPS completion | 20 (100) | 0 | |
Monosegment resection | 0 | 1 (3) | |
Left atypical | 0 | 1 (3) | |
Left hepatectomy | 0 | 1 (3) | |
Extended left hepatectomy | 0 | 1 (3) | |
Right atypical | 0 | 2 (6) | |
Right posterior resection | 0 | 2 (6) | |
Right hepatectomy | 0 | 17 (50) | |
Extended right hepatectomy | 0 | 7 (21) | |
Right trisectionectomy | 0 | 2 (6) | |
Intraoperative blood transfusion step 2 (y/n) | 11 (55)/9 (5) | 14 (41)/20 (59) | .325 |
Volumetric data | |||
Stage 1 | |||
TLV (ml) | 1672 (1589–2127) | 1574 (1366–1801) | .046 |
TV (ml) | 45 (19–342) | 23 (13–60) | .077 |
FLR (ml) | 534 (392–716) | 450 (378–560) | .364 |
cFLR (%) | 29 (25–37) | 29 (25–36) | .869 |
Stage 2 | |||
TLV (ml) | 2083 (1724–2399) | 1679 (1406–1775) | < .001 |
TV (ml) | 35 (19–103) | 26 (13–68) | .208 |
FLR (ml) | 716 (504–954) | 655 (486–744) | .448 |
cFLR (%) | 37 (30–47) | 31 (33–50) | .103 |
Degree of hypertrophy (%) | 35 (23–62) | 45 (18–69) | .803 |
Postoperative data | |||
Intensive care step 1, days | 1 (1–2) | 0 (0–1) | < .001 |
Intensive care step 2, days | 1 (0–1) | 1 (1–1) | .044 |
Hospitalization step 1 and 2, days | 32 (22–46) | 22 (17–28) | .009 |
Clavien-Dindo stage 1 ≥ IIIa, n (%) | 2 (10) | 5 (14) | .654 |
Clavien-Dindo stage 1 = V, n (%) | 0 | 0 | n.a. |
Clavien-Dindo stage 2 ≥ IIIa, n (%) | 13 (65) | 13 (38) | .057 |
Clavien-Dindo stage 2 = V, n (%) | 2 (10) | 2 (6) | .577 |
Follow-up data | |||
R0 resection | 20 (100) | 30 (88) | .116 |
Median RFS (95% CI), months | 19 (8–30) | 10 (6–14) | .050 |
Median OS (95% CI), months | 28 (19–37) | 34 (25–43) | .963 |