title: Indicators of recurrence following cryotherapy for hepatic metastases from colorectal cancer.
abstract: BACKGROUND
  This retrospective review aimed to assess the incidence of local recurrence at the cryosite, hepatic and extrahepatic recurrence and the corresponding disease-free intervals. Prognostic indicators following hepatic cryotherapy were also identified.
  
  
  METHODS
  Eighty-five patients underwent complete cryotreatment of colorectal liver metastases between April 1990 and May 1997. Possible prognostic indicators were tested for their impact on the disease-free interval at the cryosite, liver disease-free survival and overall disease-free survival with univariate and multivariate analysis.
  
  
  RESULTS
  At a median follow-up of 22 months 66 patients developed tumour recurrence: 18 in the liver only; 15 in the liver and lung; 22 in the liver and extrapulmonary areas; and 11 at extrahepatic sites only. Local recurrence at the cryosite occurred in 28 patients. Cryotreated metastases larger than 3 cm were associated with a shorter disease-free interval at the cryosite and liver disease-free survival; persistently raised serum carcinoembryonic antigen (CEA) levels after operation were associated with shorter liver disease-free and overall disease-free intervals in multivariate analysis.
  
  
  CONCLUSIONS
  Improvements in probe placement and monitoring of the freezing process are required to allow successful treatment of large liver metastases. A failure in complete postoperative CEA response indicates that hepatic or extrahepatic disease was not detected before operation, which may be avoided with better staging procedures.
authors: University of New South Wales Department of Surgery, St George Hospital, Kogarah, Sydney, Australia.
authors: J K
authors: JK
authors: Seifert
authors: D L
authors: DL
authors: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms; D017679:Cryotherapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D002272:Carcinoembryonic Antigen