title: Endoluminal cryotherapy in the management of endobronchial metastatic tumors of extrapulmonary origin.
abstract: BACKGROUND
  Endobronchial metastases from extrapulmonary tumors are rare and often cause significant symptoms particularly when they present within the main bronchial tree. Cryotherapy has been shown to be effective in the treatment of primary malignancies of the endobronchial tree. This is the first detailed analysis of the application of cryotherapy to endobronchial metastatic tumors of extrapulmonary origin. This study assessed the role of endobronchial cryotherapy in the management of these patients, including control of symptoms and improvement in endobronchial patency.
  
  
  METHODS
  The details of 35 patients treated over a 17-year period were reviewed. Patients' ages ranged from 22 to 80 years. The primary tumors were mainly colorectal and renal.
  
  
  RESULTS
  There were no perioperative or in-patient deaths. Endobronchial cryotherapy was carried out as a day-case procedure in over 80% of cases. Of the 35 patients, 30 (85%) reported a significant improvement in their main presenting symptom. In over half the patients, endoluminal patency was increased by ≥50% following 1 treatment of cryotherapy. Survival ranged from 10 days to 4 years 8 months, with a median survival of 34 weeks. One-year survival was 37.5%.
  
  
  CONCLUSIONS
  Endoluminal cryotherapy gives rapid resolution of symptoms and can be carried out as a day-case procedure in the vast majority of patients. We recommend that cryotherapy should be considered as a first-line palliation in patients with symptomatic metastases to the endobronchial tree.
authors.affiliation: Department of Thoracic Surgery, Harefield Hospital, Harefield, Middlesex, UK.
authors.forename: Donna
authors.initials: D
authors.lastname: Eaton
authors.forename: Julie
authors.initials: J
authors.lastname: Beeson
authors.forename: Omar
authors.initials: O
authors.lastname: Maiwand
authors.forename: Vladimir
authors.initials: V
authors.lastname: Anikin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000556:secondary / Q000601:surgery*; D001999:Bronchoscopy; D015179:Colorectal Neoplasms / Q000473:pathology*; D003452:Cryosurgery / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014134:Tracheal Neoplasms / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult