[Cryotherapy for primary and secondary liver tumours].
OBJECTIVE
We assessed the morbidity, mortality and efficacy of cryotherapy for primary and secondary malignant liver tumours in a prospective case control study.


METHODS
Since 1996 we performed 77 cryosurgical procedures on 71 patients. 6 patients had hepatocellular carcinoma, the remainders metastases, mainly of colorectal origin (n = 49). Cryotherapy was used when a complete tumour resection was not feasible, but complete tumour destruction by cryotherapy seemed possible. Mean follow-up was 21 months.


RESULTS
The mean number of lesions per patient was 2.6 (1-10) with a mean maximum diameter of 3.7 cm (1-11). In 36 of 71 patients cryotherapy was used in combination with liver resection. Morbidity and hospital mortality were 23 % and 2.8 %. In 25 of 34 patients with colorectal primary and preoperatively elevated CEA it returned to normal postoperatively (74 %). 40 of the 60 patients with "R0-treatment" developed tumour recurrence, 10 of these at the cryosite (17 %). Median survival for all patients (colorectal metastases) was 28 (29) months with a 3- and 5-year survival rate of 38 % (43 %) and 30 % (33 %), respectively.


CONCLUSIONS
Cryotherapy is an effective parenchyma sparing method for the treatment of malignant liver tumours in a curative approach. It can be performed safely and a long-term local tumour control is achieved in a high percentage of patients. Survival rates following cryotherapy appear comparable to the results of liver resection. It seems justified to conduct a prospective randomised trial comparing liver resection and cryotherapy for resectable tumours.
Seifert
J K
JK
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie der Johannes Gutenberg-Universität, Mainz, Germany.
Heintz
A
A
Junginger
Th
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome