Cryotherapy treatment of patients with hepatic metastases from neuroendocrine tumors

Cozzi, Paul; Englund, Raymond; Morris, David L.

doi:10.1002/1097-0142(19950801)76:3<501::aid-cncr2820760322>3.0.co;2-x

Cited by 103 publications

(30 citation statements)

References 26 publications

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“…During freeze/thaw cycles, intracellular and extracellular ice formation occurs in an area termed 'the iceball' leading to tumor destruction. Use of hepatic cryotherapy at laparotomy or laporoscopy surgery for patients with endocrine metastases has been used for a number of years (Cozzi et al 1995, Shafir et al 1996, Shapiro et al 1998, Seifert et al 1998, Duperier et al 2001, Sheen et al 2002, Tait et al 2002 and has demonstrated successful results in terms of symptom control and objective tumor responses (Cozzi et al 1995, Shapiro et al 1998, Seifert et al 1998. Cryotherapy is an important supplement to surgical resection and allows regional destruction to lesions not amenable to resection.…”

Section: Cryotherapymentioning

confidence: 99%

Ablative therapies for liver metastases of digestive endocrine tumours.

O’Toole¹,

Maire²,

Ruszniewski³

2003

Endocrine-Related Cancer

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Hepatic metastases are frequently encountered in patients with digestive endocrine tumors and their presence plays an important role in quality of life and overall prognosis. Surgery is the treatment method of choice for hepatic metastases but this is frequently impossible due to the extent of disease. Systemic chemotherapy is offered to patients with diffuse and/or progressive liver metastases but results are disappointing especially in patients with metastases of midgut origin. In the latter patients with carcinoid syndrome, somatostatin analogs are frequently initially effective but their efficacy wanes due to disease progression and development of tachyphylaxis. Other therapeutic options in the treatment of hepatic metastases are locoregional strategies where vascular occlusion induces ischemia in these highly vascular tumors using either surgical or radiological techniques. Available methods include surgical ligation of the hepatic artery, transient hepatic ischemia or sequential hepatic arterialization. Trans-catheter arterial chemoembolization has proven effective in terms of long palliation and objective tumor responses. Other treatments aimed at regional destruction either alone or in combination with surgery include radiofrequency ablation and cryotherapy. The latter are usually important adjuncts to surgery and are usually reserved for limited disease.

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Section: Cryotherapymentioning

confidence: 99%

Ablative therapies for liver metastases of digestive endocrine tumours.

O’Toole¹,

Maire²,

Ruszniewski³

2003

Endocrine-Related Cancer

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“…With technological improvements in cryotherapy equipment and intraoperative ultrasound equipment, the technique has gained more widespread acceptance [3][4][5]. To the best of our knowledge, there has been one previous report of the use of cryotherapy to treat metastatic neuroendocrine tumors [6]. This report included three patients with carcinoid tumors, only one of which had carcinoid syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Cryotherapy offers the ability to treat multiple bilobar hepatic lesions that would not be amenable to surgical resection. It also offers the ability to alleviate symptoms by destroying hormone-producing tumor cells [6].…”

Section: Discussionmentioning

confidence: 99%

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Cryotherapy of metastatic carcinoid tumors

et al. 1998

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“…In one report, cryosurgery was shown to be effective in alleviating the symptoms associated with hormonal secretion by neuroendocrine metastases. 111 Currently, cryosurgical ablation is considered an investigational form of therapy for the treatment of metastatic cancer. The efficacy of this approach, either in unresectable patients or as an alternative or adjuvant to resection, should be evaluated in the setting of formal clinical trials.…”

Section: Cryosurgery and Other Forms Of Local Hepatic Ablative Therapymentioning

confidence: 99%

Management of hepatic metastases

Choti

Bulkley

1999

Liver Transpl

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Although the liver is the most common site of metastatic disease from a variety of tumor types, isolated hepatic metastases most commonly occur from colorectal cancer and, less frequently, from neuroendocrine tumors, gastrointestinal sarcoma, ocular melanoma, and others. Complete evaluation of the extent of metastatic disease, both intrahepatically and extrahepatically, is important before considering treatment options. Based on a preponderance of uncontrolled studies for hepatic metastatic colorectal carcinoma, surgical resection offers the only potential for cure of selected patients with completely resected disease, with 5-year survival rates of 25% to 46%. Systemic and hepatic arterial infusion chemotherapy may be useful treatment options in patients with unresectable disease and possibly as an adjuvant treatment after liver resection. Other techniques of local tumor ablation, including cryotherapy and radiofrequency ablation, although promising, remain unproved. Management of hepatic metastases from neuroendocrine tumors and other noncolorectal primary tumors should be individualized based on the patient's clinical course, extent of disease, and symptoms. Copyright 1999 by the American Association for the Study of Liver DiseasesA s many as 50% of the patients with a primary malignancy will eventually develop metastases in the liver, a percentage greater than for any other organ, including the lung. Although primary tumors that drain principally into the portal circulation are more likely than others to develop hepatic metastases, many tumors arising in other sites, such as the breast and lung, also commonly develop hepatic metastases. Although the liver represents a common site of spread from many of these solid tumors, isolated hepatic metastases most commonly occur from colorectal and neuroendocrine tumors. Other less common malignancies also can metastasize predominantly to the liver. For most other solid malignancies, the pattern of metastatic disease is most often that of generalized dissemination. Colorectal MetastasesCancer of the colon and rectum is the third most commonly diagnosed cancer in the United States. An estimated 131,600 new cases will have been discovered in 1998, comprising 11% of new cancer diagnoses. 1 An estimated 56,500 deaths will occur from colorectal cancer that year, comprising 10% of all cancer deaths. 1 Although mortality from largebowel cancer has been improving over the past 30 years, largely because of improvements in early detection, diagnosis, and treatment, approximately 50% of the patients with colorectal cancer eventually die of their neoplastic disease. 1 The liver is the most commonly involved organ in patients with metastatic colorectal cancer. Approximately 20% of these patients have clinically recognizable liver metastases at the time of their primary diagnosis. 1,2 After resection of a primary colorectal cancer in the absence of apparent metastatic disease, approximately 50% of the patients will subsequently manifest metastatic liver disease. Given these figures,...

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Cryotherapy treatment of patients with hepatic metastases from neuroendocrine tumors

Cited by 103 publications

References 26 publications

Ablative therapies for liver metastases of digestive endocrine tumours.

Ablative therapies for liver metastases of digestive endocrine tumours.

Cryotherapy of metastatic carcinoid tumors

Management of hepatic metastases

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