Hepatobiliary malignacies

We conduct clinical studies and collaborate on translational studies for the treatment of hepatobiliary malignancies.

About the group

We have recently completed two major clinical trials address key issues in liver surgery (ALPPS and laparoscopic liver resection). We are currently putting all our effort in the ASAC trial but continuously work on hypotheses for new RCTs.

Our clinical department is a major provider of surgical specimens necessary for translational research. We therefore focus on close partnership with several key research groups within the field of molecular medicine and tumor Genetics.

The groups goal is to ensure adequate research infrastructure and financing to make sure that clinical and translational hepatobiliary research activity becomes an integrated part of all aspects of the day to day practice in our Department.

The main aim of the research group is to conduct clinical and translational studies for the treatment of hepatobiliary malignancies. The group has also register-based studies to evaluate and improve patient treatment.

Projects

The ASAC study, Scandinavian multicentre, placebo-controlled, randomized trial, initiated by our group, investigating the role of aspirin as adjuvant after surgery for colorectal liver metastases (www.asac.no). The trial is funded by Research Council of Norway, Norwegian Cancer Society, and KLINBEFORSK.
EXCALIBUR study; single centre, un-blinded, three-armed randomized trial for patients with high load of colorectal liver metastases, treated with 1)liver transplantation 2)liver resection 3)hepatic artery infusion of chemotherapy. The trial is funded by South-East Norwegian health care authority (HSØ) (www.excaliburstudy.com).
Precision Medicine in Early Diagnostics and Therapy of Biliary Tract Cancer; is a collaborative project between several groups, led by Sheraz Yaqub.
TESLA1 & TESLA2 trial: Liver Transplantation for Non-Resectable Intrahepatic Cholangiocarcinoma (TESLA1) and perihilar cholangiocarcinoma (TESLA2) are prospective exploratory trials. These are collaborative studies between several groups at OUH-KIT treating patients with cholangiocarcinoma.
NEW-COMET trial; double-blinded RCT on liver resection vs thermal ablation for colorectal liver metastases (n=260 patients). The study is funded by South-East Norwegian health care authority (HSØ).
The EVIDENT trial (Ex vivo drug sensitivity testing of metastatic colorectal cancer) is a prospective, single-arm phase II study of metastatic CRC, in which patients will receive standard or experimental anticancer agents guided by a combination of molecular markers and PDO drug sensitivities led by Prof Ragnhild Lothe.
PREPOSTEROUS; a single blinded trial, initiated by University of Helsinki, investigating the role of low-molecular heparin administered pre-operatively vs. post-operatively.
LIVACOR trial; International multicentre randomized trial comparing simultaneous and two-staged resection of colon cancer with synchronous liver metastases with regards to Time to functional recovery. OUH is the Norwegian site that recruits patients.

Planned projects

The SYLMET trial; a multicentre, randomized controlled trial, comparing simultaneous and two-staged resection of primary colorectal cancer with synchronous liver metastases.

Cooperation

Internal

Professor Bjørn Edwin Intervensjonssenteret
Professor Ragnhild Lothe og Jebsen senteret for tarmkreftforskning ved DNR
Professor Kjetil Taskèn, Norwegian Center for Molecular Medicine
Professor Kjersti Flatmark, Oslo University Hosptal, DNR

National

All HPB departments at the other University Hospitals in Norway in the ASAC-study (a randomized controlled Multicenter study for the effect of adjuvant ASA following resection of colorectal liver metastases)

International

Scandinavian network on HPB Surgery on several collaborative studies with the University Hospitals in Lund, Gothenburg, Linkøping, Stocholm, Uppsala (Sweden) and Rigshospitalet, Copenhagen (Denmark) through the IHPBA Scandinavian Chapter.

Selected Publications

(excluding other publications without direct hepatobiliary relevance)

Fretland ÅA, Kazaryan AM, Edwin B. Laparoscopic Resection for Liver Malignancies: Do the Elderly Benefit More? J Invest Surg. 2017 Nov 8:1-2.
Østrup O, Dagenborg VJ, Rødland EA, Skarpeteig V, Silwal-Pandit L, Grzyb K, Berstad AE, Fretland ÅA, Mælandsmo GM, Børresen-Dale AL, Ree AH, Edwin B, Nygaard V, Flatmark K. Molecular signatures reflecting microenvironmental metabolism and chemotherapy-induced immunogenic cell death in colorectal liver metastases. Oncotarget. 2017 Jul 18;8(44):76290-76304.
Abu Hilal M, Aldrighetti L, Dagher I, Edwin B, et al. The Southampton Consensus Guidelines for Laparoscopic Liver Surgery: From Indication to Implementation. Ann Surg. 2017 Oct 23.
Halls MC, Cherqui D, Taylor MA, Primrose JN, Abu Hilal M; Collaborators of The Difficulty of Laparoscopic Liver Surgery Survey. Are the current difficulty scores for laparoscopic liver surgery telling the whole story? An international survey and recommendations for the future. HPB (Oxford). 2017 Sep 29. pii: S1365-182X(17)30926-7.
Aghayan DL, Kazaryan AM, Fretland ÅA, Sahakyan MA, Røsok BI, Bjørnbeth BA, Edwin B. Laparoscopic liver resection for metastatic melanoma. Surg Endosc. 2018 Mar;32(3):1470-1477.
Berardi G, Van Cleven S, Fretland ÅA, Barkhatov L, Halls M, Cipriani F, Aldrighetti L, Abu Hilal M, Edwin B, Troisi RI. Evolution of Laparoscopic Liver Surgery from Innovation to Implementation to Mastery: Perioperative and Oncologic Outcomes of 2,238 Patients from 4 European Specialized Centers. J Am Coll Surg. 2017 Nov;225(5):639-649.
Cipriani F, Fantini C, Ratti F, Lauro R, Tranchart H, Halls M, Scuderi V, Barkhatov L, Edwin B, et al. Laparoscopic liver resections for hepatocellular carcinoma. Can we extend the surgical indication in cirrhotic patients? Surg Endosc. 2018 Feb;32(2):617-626.
Halls MC, Cipriani F, Berardi G, Barkhatov L, Lainas P, Alzoubi M, D'Hondt M, Rotellar F, Dagher I, Aldrighetti L, Troisi RI, Edwin B, Hilal MA. Conversion for Unfavorable Intraoperative Events Results in Significantly Worst Outcomes During Laparoscopic Liver Resection: Lessons Learned From a Multicenter Review of 2861 Cases. Ann Surg. 2017 Jun 2.
Brudvik KW, Jones RP, Giuliante F, Shindoh J, Passot G, Chung MH, Song J, Li L, Dagenborg VJ, Fretland ÅA, Røsok B, De Rose AM, Ardito F, Edwin B, Panettieri E, Larocca LM, Yamashita S, Conrad C, Aloia TA, Poston GJ, Bjørnbeth BA, Vauthey JN. RAS Mutation Clinical Risk Score to Predict Survival After Resection of Colorectal Liver Metastases. Ann Surg. 2017 May 25.
Palomar R, Cheikh FA, Edwin B, Fretland Å, Beghdadi A, Elle OJ. A novel method for planning liver resections using deformable Bézier surfaces and distance maps. Comput Methods Programs Biomed. 2017 Jun;144:135-145