Cryotherapy for liver metastases

Abstract

Background The liver is a ected by two of the most common groups of malignant tumours: primary liver tumours and liver metastases from colorectal carcinoma. Liver metastases are significantly more common than primary liver cancer and long-term survival rates reported for patients a er radical surgical treatment is approximately 50%. However, R0 resection (resection for cure) is not feasible in the majority of patients. Cryotherapy is performed with the use of an image-guided cryoprobe which delivers liquid nitrogen or argon gas to the tumour tissue. The subsequent process of freezing is associated with formation of ice crystals, which directly damage exposed tissue, including cancer cells. Objectives To assess the beneficial and harmful e ects of cryotherapy compared with no intervention, other ablation methods, or systemic treatments in people with liver metastases. Search methods We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, and six other databases up to June 2018. Selection criteria Randomised clinical trials assessing beneficial and harmful e ects of cryotherapy and its comparators for liver metastases, irrespective of the location of the primary tumour. Data collection and analysis We used standard methodological procedures expected by Cochrane. We extracted information on participant characteristics, interventions, study outcomes, and data on the outcomes important for our review, as well as information on the design and methodology of the trials. Two review authors independently assessed risk of bias in each study. One review author performed data extraction and a second review author checked entries.

Local Treatments in the Unresectable Patient with Colorectal Cancer Metastasis: A Review from the Point of View of the Medical Oncologist

“…No significant differences were found. Reported adverse events were similar between groups (10% and 20%), except in the case of pain, which was worse in the cryotherapy group [ 98 , 99 ].…”

“…This trial randomized 123 consecutive patients (82 patients with LMCRC) to cryosurgery versus conventional surgery. A high risk of bias is present, as there is no information provided to assess the sequence generation or allocation concealment [ 99 ]. The cryosurgery consisted of diverse procedures, including cryoresection using a self-constructed cryogenic clamp to freeze the desired incision line, and cryoablation.…”

Rethinking Antigen Source: Cancer Vaccines Based on Whole Tumor Cell/tissue Lysate or Whole Tumor Cell

“…Ice crystal formation during the rapid freezing process causes destruction of the cellular structure and kills the tumor cells. [138] Colorectal tumor tissue was surgically resected and cryopreserved in liquid nitrogen to detect protein markers on the tumor surface, which can be used for preoperative detection. [139] Patel et al analyzed gene expression profiles in 68 stage I and 15 borderline ovarian cancers to determine whether different clinical characteristics (such as tissue type, grade, and survival) of stage I ovarian cancer were associated with differences in gene expression.…”

Interventional oncology at the time of COVID-19 pandemic: Problems and solutions

“…Isolation of the diaphragm during thermal ablation of sub diaphragmatic liver tumors is also potentially useful since it reduced significantly the 24 hours cumulative dose of morphine by a factor of 20 [15]. One other option for liver [16,17] or lung [18,19] tumors ablation is to use cryotherapy instead of radiofrequency ablation (RFA) or microwave ablation. Although this method has been less reported than thermal hot ablation techniques, this method has the advantage of being painless during treatment.…”