Cryoablation and liver resection for noncolorectal liver metastases.
BACKGROUND
Liver resection for noncolorectal liver metastases has merit for selected primary tumor types. The role of cryosurgical tumor ablation within this cohort of patients has not been evaluated. This is a single institutional review of treatment outcomes using cryosurgical ablation and conventional resection techniques for noncolorectal liver metastases.


METHODS
The medical records of 42 patients undergoing 48 hepatic tumor ablative procedures from February 1991 through May 2001 at a single institution were retrospectively reviewed. Overall survival and local hepatic tumor recurrence-free survival were analyzed for different surgical procedures and primary tumor types.


RESULTS
Overall survival rates at 1, 3, and 5 years are 82%, 55%, and 39%, respectively (median survival, 45 months). Local hepatic tumor recurrence-free survival rates for resection only (n = 25) and cryosurgery with or without resection (n = 23), at 3 years are 24% and 19%, respectively. The survival rates at 5 years are 40% and 37%, for resection only and cryosurgery with or without resection, respectively.


CONCLUSIONS
Cryosurgical hepatic tumor ablation for metastatic noncolorectal primary tumors results in survival and local hepatic tumor recurrence rates similar to resection alone. The combination of cryosurgery and resection extends the cohort of patients with surgically treatable disease.
Goering
John D
JD
University of Wisconsin-Madison, Department of Surgery Division of General Surgery, H4/710 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
Mahvi
David M
DM
Niederhuber
John E
JE
Chicks
Deb
D
Rikkers
Layton F
LF
D000293:Adolescent; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000473:pathology; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000401:mortality / Q000556:secondary / Q000601:surgery