ALPS 2016 Meeting, Madonna di Campiglio
Delegates gathered once again for the 11th Alpine Liver and Pancreatic Meeting (ALPS) in Madonna di Campiglio in Italy.
The first session commenced with a tribute to Paul Peters, Groningen, who had recently retired following a distinguished career developing and setting up paediatric liver transplantation in the Netherlands. Paul went on to describe his experience over many years in this difficult specialty, candidly recalling the problems as well as the successes. Following this excellent start to the meeting everyone made the usual dash for the boot room in order to get out onto the slopes.
Despite concerns over the low snowfall this season, we were all relieved to find that the resort had worked hard to ensure that the pistes were in good condition. The Norwegian and Dutch delegates, renowned for putting us all to shame with their skiing ability, were this year tested by Peter Allen’s wife Sarah from New York. The New England ice fields (pistes) clearly develop a high level of skill. Peter’s contention that he was actually faster due to a much higher mass was treated with some scepticism. Certainly Sarah had both style and speed.
After an excellent days skiing, with the occasional break for hot chocolate or grappa, the group returned in time for an update on the oncological management of colorectal liver metastases by medical oncologist John Bridgewater, UCL. The mainly surgical audience warmed to his “surgery cures cancer” approach that was followed by Steven Olde Damink, Masstricht, talking about neoadjuvant chemotherapy. John Primrose and Marc Bemelmans strictly chaired the whole session in order to ensure a timely departure for the evening’s activities up the mountain at Chalet Fiat. Following a short cable car ride and candlelit walk across the snow all sat down to enjoy an excellent mountain top meal followed by dancing.
Friday morning was the usual early start, irrespective of the previous evening’s bedtime, in order to hear about biliary tract cancer. Minds were stretched in a scientific talk by Clinical Lecturer from Edinburgh Rachel Guest on cholangiocarcinoma. Following the session a day on the slopes was again enjoyed by all, although for some there was the welcome interruption of lunch at Chalet Fiat. We were delighted to find that whilst Paul Peters never normally eats lunch, not even during a transplant, he was willing to participate on this occasion. Post lunch skiing was noticeably influenced by the excellent wine consumed, following which everyone returned to the hotel for a session opened by Åsmund Fretland, Oslo talking about the Oslo-CoMET trial.
Saturday morning saw the return of the perioperative team educating us on fitness for surgery. One of the chairs looked slightly uncomfortable as Denny Levitt, Southampton talked about increased mortality associated with obesity. Then others of us felt uneasy as the team went on to tell us that fat and fit is ok but slim and unfit is not. Whatever your size, it was a good excuse to get back to the slopes and pack in some skiing.
The Saturday evening session followed a more conventional approach this year, but in no way did it disappoint. Peter Allen, New York delivered two fantastic talks on the topics of pancreatic fistulas and IPMN. Perhaps for the first time (for those not particularly enthusiastic about the pancreas) IPMN and its problems were made understandable. The talk on a clinical trial on the prevention of pancreatic fistulas with somatostatin analogues shows that the USA has finally caught up with Europe (after 20 years)! These talks were complimented by David Tuveson, New York, giving a talk aptly entitled “ALPS” in which he outlined his vision for the use of pancreatic cancer organoids in personalising therapy. The gala dinner followed with presentation of prizes. Kristoffer Brudvik from Oslo was awarded the prize for best presentation by a trainee for his paper on “Survival impact of KRAS after resection of CRLMs”. Unusually the prize for the worse ski injury was not awarded. Duncan Jodrell, Cambridge (oncologist) made a bid for the prize relating to a bruise on his torso but the committee (of surgeons) felt the application had no merit and lacked substance.
Lastly, thank you to the organising committee for arranging such a high quality multidisciplinary group of speakers. Thank you also to our industry sponsors (Sirtex, Lotus) and all who attended for a superb 11th meeting of ALPS.