Cryosurgery: Its Role in Liver Tumours

Reprints available directly from the publisher Photocopying permitted by license only (1991) A 5-year study of cryosurgery in the treatment of liver tumours. Archives of This report summarizes our 5-year experience with cryosurgery for in situ ablation of liver tumors. The liver was exposed with laparotomy, and the tumors were subjected to two freeze-thaw cycles using liquid nitrogen delivered by insulated probes; cryoablation was monitored with intra-operative ultrasonography. Tumor markers and computed tomography evaluated tumor response during long-term follow-up. From 1985 to 1990, 32 patients (19 men and 13 women) were entered into this study. The histologic characteristics of the tumors were as follows" colorectal, 24 patients; hepatoma, three patients; neuroendocrine, two patients; and others, three patients. After a follow-up period of 5 to 60 months (median follow-up, 24 months), nine patients (28%) remained disease free, 11 patients (34%) were alive with disease, and 12 patients (38%) died. The patterns of failure included liver and extrahepatic disease in 54% of cases, liver disease only in 32% of cases, and extrahepatic disease only in 14% of cases. In patients with "liver only" failure, recurrence at the treatment site occurred in three patients (9%). This study establishes the long-term effectiveness of cryosurgery in the treatment of primary and metastatic liver tumors. PAPER DISCUSSION KEY WORDS" Liver secondary carcinoma, cryosurgery This paper reports the use of cryosurgery in the treatment of liver tumours and raises two interesting issues: the value of cryodestruction as a technique for destroying malignant tumours in general and more specifically for the management of liver tumours.