title: Palliative cryosurgery for rectal carcinoma.
abstract: Cryosurgery is one of the palliative treatment options to decrease local symptoms due to rectal carcinoma. A total of 106 patients (aged 45-92 years) underwent palliative cryosurgery for primary rectal cancer. Inclusion criteria were prohibitive surgical risk, unresectability, distant metastases, patient refusal of surgical intervention, and old age. The palliative effect of cryosurgery on local symptoms was classified as good, moderate, or none. The duration of palliation was calculated in relation to survival as a palliative index: the number of months of (moderate or good) palliation divided by the number of months of survival from the start of the treatment, multiplied by 100. In 66 patients (62%) there was complete relief of local symptoms, with a palliative index of 88%. In 17 patients (16%) palliation was moderate, and in 23 patients (22%) no palliation was achieved. The 50% survival duration in the 66 patients was 33 months. Especially symptoms of blood and/or mucous discharge were easily alleviated. Good alleviation of local symptoms was associated with the extent of the primary tumor process. Palliative effect was be assessed after a few treatments. Patients with circular rectal tumors seldom had long-term palliative effects of cryosurgery. Our findings show that Cryosurgery is a simple and safe treatment for rectal cancer. It should be considered for alleviation of local symptoms in patients with rectal cancer who are unsuitable for radical surgery.
authors.affiliation: Department of Surgical Oncology, Free University Hospital, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands, s.meijer@azvu.nl
authors.forename: S
authors.initials: S
authors.lastname: Meijer
authors.forename: F D
authors.initials: FD
authors.lastname: Rahusen
authors.forename: L G
authors.initials: LG
authors.lastname: van der Plas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism; D010146:Pain; D010166:Palliative Care; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome