Alveolar Echinococcosis: Is Non-Radical Liver Resection a Game Changer in the Current Treatment Approach to Patients with Advanced Alveolar Echinococcosis Disease? Single Center Experience of Poland.

BACKGROUND: Alveolar echinococcosis is parasitic disease caused by Echinococcus multilocularis and spread endemically in the northern hemisphere. Although alveolar echinococcosis is considered a rare disease, with approximately 18,000 new cases diagnosed annually, it continues to present significant diagnostic and therapeutic challenges. Alveolar echinococcosis affects the liver through slow, asymptomatic infiltration over many years. At the time of diagnosis, approximately 70% of cases are not eligible for radical lesion resection. The aim of the study was to evaluate whether non-radical surgery increases patients' survival rates.

METHODS: We conducted a prospective analysis on patients diagnosed with alveolar echinococcosis in years 1995-2017 who underwent liver resection. Age, gender, mass of lesion, extensive nature of the operation (radical vs. conservative) and surgical procedures were collected. Mortality was analyzed.

RESULTS: Mean resected lesions' weight was statistically higher in non-radically resected group 1396,00 g (SD ± 845,39) compared with radically resected group 549,43 g (SD ± 364,27), p = 0,004. The type of surgical treatment did not significantly affect patient survival.

CONCLUSION: The complete lesion resection (in combination with albendazole) is only a curative therapy, if feasible. In advance stages when radical resection is not feasible, the reductive or debulking surgery should be done for symptoms' alleviation and quality of life improvement.