J Surg. 2003 Feb;90(2):248.
Cryotherapeutic ablation of liver tumours.
Sheen AJ, Poston GJ, Sherlock DJ.
Department of Surgery, North
Manchester Healthcare NHS Trust, Manchester, UK.
BACKGROUND: This paper reports a 7-year experience
of cryoablation for colorectal and non-colorectal liver metastases.
METHODS: A retrospective review was undertaken of patients treated
in two adjacent UK centres in the north-west of England. RESULTS:
Over a 7-year period (1993-2000), 57 patients underwent cryotherapy
for malignant hepatic tumours (41 colorectal, 16 non-colorectal).
In the patients with colorectal metastases, preoperative carcinoembryonic
antigen (CEA) levels fell significantly, from a mean of 444.1 to
6.22 micro g/l (P = 0.002). One patient died, two developed cryoshock
and six had cardiorespiratory complications. All patients with colorectal
metastases subsequently received 5-fluorouracil-based chemotherapy.
The remaining 16 patients with non-colorectal tumours (seven neuroendocrine
metastases, five hepatocellular carcinomas, three sarcomas, one
cholangiocarcinoma) all received cryotherapy alone, with no major
complications. The median survival for patients with non-colorectal
metastases was 37 months, compared with 22 months for those with
colorectal metastases (P = 0.005). CONCLUSION: Hepatic cryotherapy
is effective and safe, as demonstrated by the significant reduction
in postoperative CEA concentration and the low risk of complications.
However, this initial short-term success was not reflected in 5-year
survival rates. Cryotherapy for non-colorectal metastases had a
greater long-term survival benefit and is a useful means of controlling
· Multicenter Study
PMID: 12390380 [PubMed - indexed for MEDLINE]