Percutaneous cryosurgery was performed successfully in two patients with hypervascular renal tumours. Cryo-immunological activity was assumed to have contributed to the temporary improvement in their condition. These results suggest that percutaneous cryosurgery might be useful as minimally invasive treatment in a limited number of patients with advanced renal carcinoma.

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Studies have demonstrated a relationship between clinical outcomes after curative resection for colorectal cancer (CRC) and gene mutations of the EGFR pathway; however, no studies have examined metastatic CRC (mCRC) patients with metastasectomy. The aim of this study was to evaluate the relationship between gene mutations of EGFR pathway and clinical outcomes after metastasectomy in mCRC patients. A total of 1,053 patients histopathologically confirmed CRC received a genotyping test for the EGFR pathway from February 2012 to October 2013. Detailed information was obtained through review of medical records. Gene mutations of EGFR pathway were analyzed by Luminex assay. Overall survival (OS) and recurrence free survival were estimated by the Kaplan-Meier method and the log-rank test was used to compare the survival outcomes by gene mutation status. A total of 132 patients received metastasectomy. The frequencies of KRAS exon 2, KRAS exon 3.4, NRAS, BRAF, and PIK3CA mutations were 38.6% (51/132), 3.6% (5/132), 5.1% (7/132), 5.1% (7/132), and 8.7% (12/132), respectively. With a median follow-up of 84.1 months (57.2-NA) for a survivor, the 4-year OS rate was 65.6% for mCRC with RAS mutation, and 81.3% for mCRC with wild-type RAS (p < 0.05). We observed a statistically significant correlation for only the RAS mutation and OS. In multivariate analysis, RAS mutation and liver metastasis were independent factors for shorter OS. There were no significant differences between gene mutations of EGFR pathway and recurrence free survival. RAS mutation in mCRC metastasectomy patients was associated with shorter overall survival.In the field of developing chemotherapy for metastatic colorectal cancer (mCRC) patients, RAS mutation is considered not only a predictive factor for the efficacy of anti-EGFR treatment but also a potential prognostic factor. However, the prognostic value of KRAS mutations in patients with resectable colorectal cancer (CRC) remains controversial. Current pivotal phase 3 trials, such as FIRE-3 and CALGB80405, have demonstrated that overall survival (OS) in patients with KRAS wild-type mCRC is longer than 30 months, as compared with an OS of less 20 months in patients with mCRC whose tumors harbor KRAS exon 2 mutations. 1,2 Roth et al. suggested that KRAS mutations did not have a major prognostic value regarding recurrence free survival (RFS) and OS in PETACC-3, EORTC 40993, and SAKK 60-00 trials of patients with stage II and III resected colon cancer (RFS: HR 1.05, p 5 0.66; OS: HR 1.09, p 5 0.48). 3 Fariña-Sarasqueta et al. suggested that stage III patients with KRAS mutations displayed significantly worse disease-free survival compared with those with wild-type KRAS (HR 0.6, p 5 0.03). 4 Furthermore, an N0147 trial assessing the potential benefit from cetuximab treatment combined with FOLFOX in patients with resected stage III CRC showed that the 3-year disease-free survival in patients with wild-type KRAS Key words: biomarker, RAS mutation, metastasectomy of colon cancer, repeat metastasectomy Abbrevia...

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