Cryosurgery: Early Ultrastructural Changes in Liver Tissue In Vivo

Korpan, Nikolai N.

doi:10.1016/j.jss.2008.02.063

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…Recent technological advances and promising investigational studies support the use of cryoablation as a robust ablative therapy with demonstrated efficacy in a number of cancers, including prostate, kidney, liver, and breast, as well as metastatic lesions [ 11 , 12 , 13 , 14 , 15 ]. Cryoablation has also been extensively utilized for other nonresectable primary and secondary (e.g., colon, gastric) cancers [ 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

An In Vitro Investigation into Cryoablation and Adjunctive Cryoablation/Chemotherapy Combination Therapy for the Treatment of Pancreatic Cancer Using the PANC-1 Cell Line

et al. 2022

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As the incidence of pancreatic ductal adenocarcinoma (PDAC) continues to grow, so does the need for new strategies for treatment. One such area being evaluated is cryoablation. While promising, studies remain limited and questions surrounding basic dosing (minimal lethal temperature) coupled with technological issues associated with accessing PDAC tumors and tumor proximity to vasculature and bile ducts, among others, have limited the use of cryoablation. Additionally, as chemotherapy remains the first-line of attack for PDAC, there is limited information on the impact of combining freezing with chemotherapy. As such, this study investigated the in vitro response of a PDAC cell line to freezing, chemotherapy, and the combination of chemotherapy pre-treatment and freezing. PANC-1 cells and PANC-1 tumor models were exposed to cryoablation (freezing insult) and compared to non-frozen controls. Additionally, PANC-1 cells were exposed to varying sub-clinical doses of gemcitabine or oxaliplatin alone and in combination with freezing. The results show that freezing to −10 °C did not affect viability, whereas −15 °C and −20 °C resulted in a reduction in 1 day post-freeze viability to 85% and 20%, respectively, though both recovered to controls by day 7. A complete cell loss was found following a single freeze below −25 °C. The combination of 100 nM gemcitabine (1.1 mg/m2) pre-treatment and a single freeze at −15 °C resulted in near-complete cell death (<5% survival) over the 7-day assessment interval. The combination of 8.8 µM oxaliplatin (130 mg/m2) pre-treatment and a single −15 °C freeze resulted in a similar trend of increased PANC-1 cell death. In summary, these in vitro results suggest that freezing alone to temperatures in the range of −25 °C results in a high degree of PDAC destruction. Further, the data support a potential combinatorial chemo/cryo-therapeutic strategy for the treatment of PDAC. These results suggest that a reduction in chemotherapeutic dose may be possible when offered in combination with freezing for the treatment of PDAC.

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Section: Introductionmentioning

confidence: 99%

An In Vitro Investigation into Cryoablation and Adjunctive Cryoablation/Chemotherapy Combination Therapy for the Treatment of Pancreatic Cancer Using the PANC-1 Cell Line

et al. 2022

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“…CA has also been extensively utilized for nonresectable primary and secondary (e.g. colon, gastric) cancers [12][13][14][15]. Studies have shown that CA is most effective in liver cancer for tumors ≤4 cm [9].…”

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confidence: 99%

Investigation of Liver Cancer Cell Response to Cryoablation and AdjunctiveBased Cryo Chemotherapy

2020

Br J Cancer Res

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The incidence of liver cancer has more than tripled in the last 40 years. The American Cancer Society estimates 42,810 new cases will be diagnosed and 30,000 will die from liver cancer in 2020 in the US alone [1]. Current treatment depends on staging, with early stage tumors defined as potentially resectable. In cases where surgery is not possible due to tumor size, proximity to blood vessels, or other factors chemotherapy, targeted molecule therapy, and immunotherapy via systemic or intrahepatic infusion are often employed. Thermal ablation techniques, such as radiofrequency (RFA) or cryoablation (CA), are also often utilized. For advanced metastatic disease, treatment with small molecules like sorafenib or Lenvatinib can slow disease progression but are not curative [2].Liver cancer is now being treated using thermal ablation (RFA, HiFu and CA). The advantages of the various ablative treatment approaches over surgical excision are similar given that they are relatively non-invasive and can be performed percutaneously or laparoscopically. Each has been shown to be

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“…The clinical validation of our tumor fluid management protocol during breast conserving surgery will require additional steps. Although we could not demonstrate, whether and to which degree, the resection of a frozen breast tumor decreases or prevents cell shedding from tumor manipulation, our cryosurgical technique intended to kill as many cells as possible [51][52][53][54] . Given that the freeze-thaw process intervening during cryoablation or cryoresection induces tumor necrosis and apoptosis, which may modulate antitumor immunity, our protocol could reinforce the latter with local cytotoxic and/or immuno-modulator [54][55][56][57] .…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Cryosurgical Freezing Assists with Local Drug Delivery and Targeting of Tumor Fluids in VX2 Model, which Translates in Locoregional Drug Targeting of Tumor Fluids during Cryoprobe-Assisted Surgical Resection of Breast Cancer

Pivert¹,

Xiao²,

He³

et al. 2019

Preprint

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Background: We assess locoregional drug targeting effectiveness of intraoperative (IO) cryoprobe-assisted injection of blue dye (BD) and cytotoxic-tracer mixture (TTM), in VX2 tumor model, and its translational value to cryo-assisted breast tumor surgery with BD alone. Methods: Under computed tomography (CT) guidance, we injected two ml TTM in five aliquots in the margin of 16 frozen or normothermic VX2 tumors.  We evaluated the IO and post-operative drug targeting and therapeutic efficacy in tumor-host interface (T-HI) by CT, gross examination, and histopathology. In twenty-six T1 to T4 primary breast cancer (BRCA) we performed ultrasound-guided (US) cryoprobe-assisted tumor freezing, BD guided lymphatic mapping, and surgery. We evaluated, IO and in freshly resected specimen, BD distribution pattern in T-HI, lymph node(s), breast parenchyma, and resection cavity. Results: Fluids-impervious frozen VX2 or breast tumor transported drug(s) an arc-like pattern at T-HI regardless of freeze dose, number of freeze-thaw cycles, drug dose fractionation, tumor characteristics or dimensions. During melting, TTM spread within fifty percent VX2 tumor mirrored that of T-HI; it was massive in normothermia. In VX2 twenty percent focal margin necrosis at pathology coincided with CT gap; in both studies, BD dose-staining spread in T-HI and tumor was linear. Eighty-four patients had one to twelve stained axillary lymph nodes; sixty-nine percent and all respectively, had another quadrant and resection cavity stained. Conclusion: Intraoperative freezing-assisted drug delivery and targeting techniques during cryoablation of VX2 tumor translate successfully to locoregional BD targeting, lymphatic mapping during cryo-assisted surgery of breast cancer.  

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Cryosurgery: Early Ultrastructural Changes in Liver Tissue In Vivo

Cited by 11 publications

References 22 publications

An In Vitro Investigation into Cryoablation and Adjunctive Cryoablation/Chemotherapy Combination Therapy for the Treatment of Pancreatic Cancer Using the PANC-1 Cell Line

An In Vitro Investigation into Cryoablation and Adjunctive Cryoablation/Chemotherapy Combination Therapy for the Treatment of Pancreatic Cancer Using the PANC-1 Cell Line

Investigation of Liver Cancer Cell Response to Cryoablation and AdjunctiveBased Cryo Chemotherapy

Intraoperative Cryosurgical Freezing Assists with Local Drug Delivery and Targeting of Tumor Fluids in VX2 Model, which Translates in Locoregional Drug Targeting of Tumor Fluids during Cryoprobe-Assisted Surgical Resection of Breast Cancer

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