Cryoablation of unresectable malignant liver tumors.
BACKGROUND
Unresectable malignant liver tumors, particularly metastases of gastrointestinal origin, are rapidly lethal in a vast majority of patients, regardless of treatment.


METHODS
We evaluated 58 patients by laparoscopy and/or laparotomy. Thirty-nine were treated with cryoablation of liver tumors using a liquid-nitrogen cryoprobe delivering a tumoricidal temperature of -196 degrees C with intraoperative ultrasound monitoring. Histologic evaluation showed that 25 patients had colorectal metastases, 3 had gastric tumors, 4 hepatocellular carcinomas, 6 carcinoids, and 1 gastrinoma.


RESULTS
All patients who received complete cryoablation are alive with a mean follow-up of 14 months. Five whose treatment could not be completed died between 3 and 9 months postoperatively. Thirteen patients (28%) have recurrent disease and 20 (51%) have no evidence of disease. There were no operative mortalities. Postoperative transient elevation of liver function tests and thrombocytopenia were noted. All patients received postoperative chemotherapy.


CONCLUSIONS
Cryoablation is an active and safe treatment for advanced liver malignancies.
Shafir
M
M
Department of Surgery, Mount Sinai School of Medicine, New York, New York, USA.
Shapiro
R
R
Sung
M
M
Warner
R
R
Sicular
A
A
Klipfel
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D003452:Cryosurgery / Q000379:methods / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D015408:Gastrinoma / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000473:pathology; D013921:Thrombocytopenia / Q000209:etiology; D016896:Treatment Outcome; D014463:Ultrasonography