title: A 5-year study of cryosurgery in the treatment of liver tumors.
abstract: 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 intraoperative 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.
authors.affiliation: Department of Surgery, Yale University School of Medicine, New Haven, CT 06510.
authors.forename: T S
authors.initials: TS
authors.lastname: Ravikumar
authors.forename: R
authors.initials: R
authors.lastname: Kane
authors.forename: B
authors.initials: B
authors.lastname: Cady
authors.forename: R
authors.initials: R
authors.lastname: Jenkins
authors.forename: M
authors.initials: M
authors.lastname: Clouse
authors.forename: G
authors.initials: G
authors.lastname: Steele
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015996:Survival Rate