Ultrasound-guided percutaneous cryotherapy of hepatocellular carcinoma

Chen, H.W.; Lai, Eric C. H.; Zhen, Zuo Jun; Cui, Weizhen; Liao, Shenglong; Lau, Wan Yee

doi:10.1016/j.ijsu.2010.11.008

Cited by 45 publications

(22 citation statements)

References 16 publications

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“…Percutaneous cryoablation is believed to ablate cancer cells by several mechanisms including direct cell injury, vascular injury and ischemia, apoptosis, and immunomodulation [80,81]. The advantages of cryoablation, compared with other ablative techniques, are as follows: (1) it allows for visualization of the ‘ice ball' using noncontrast computed tomography [82], ultrasound [83], or magnetic resonance imaging [84] monitoring, which permits more precise evaluation of the ablated zone in real time; (2) it causes less pain and can be performed under moderate sedation, making it feasible for patients who are poor candidates for anesthesia [85], and (3) it maintains cellular integrity of connective tissue in the vessel walls, or adjacent visceral linings, such as the gallbladder, bowel, and kidney [86]. Despite the technical advantages, cryoablation has a potentially life-threatening complication, cryoshock syndrome, which is characterized by thrombocytopenia, multiorgan failure, and disseminated intravascular coagulopathy, specific for cryotherapy in large HCC [87,88].…”

Section: Local Ablative Therapymentioning

confidence: 99%

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Shi

Zhai

2016

Gastrointest Tumors

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Background: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Hepatic resection and liver transplantation are considered to be the preferred treatment for HCC. However, as novel therapeutic options such as image-guided locoregional therapies have emerged and been refined, the manner in which HCC is treated has changed dramatically compared with what it was considered just 2 decades earlier. Summary: This study reviews the current results of various image-guided locoregional therapies for treating HCC, especially focusing on thermal ablative and transarterial techniques. Key Message: Advances in image-guided locoregional therapies, including local ablative therapy and transarterial therapy, have led to a major breakthrough in the management of HCC. Both survival rates and cure rates of patients with HCC have improved markedly since the introduction of these techniques. Practical Implications: Radiofrequency ablation is currently considered as an alternative to surgical resection for patients with early-stage HCC. A newer technique of ablation such as microwave ablation is increasingly being used, especially for large HCC. Transarterial chemoembolization has become a standard care for asymptomatic patients with multinodular tumors in intermediate-stage disease, and transarterial radioembolization has become the method of choice in HCC cases with portal vein thrombosis. Moreover, combination treatment modalities, such as thermal-based ablation combined with transarterial chemoembolization or ¹²⁵I seed implant brachytherapy, may further broaden their clinical indications for HCC. Moreover, use of localized radiation in combination with thermal ablation has been reported to improve tumor control and long-term survival.

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Section: Local Ablative Therapymentioning

confidence: 99%

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Shi

Zhai

2016

Gastrointest Tumors

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“…Ultrasound-guided percutaneous cryotherapy proved to be effective and safe in patients with unresectable and recurrent hcc (mean tumour size: 2.8 ± 1.7 cm), with 1-and 3-year survival rates calculated to be 81.4% and 60.3% respectively. The disease-free survival rate was 67.6% and 20.8% at 1 and 3 years respectively 66 (Table ii). In a recent meta-analysis comparing cryosurgery with rfa, rfa was found to be superior in terms of the local recurrence rate (odds ratio: 1.96; 95% confidence interval: 1.12 to 3.42) 67 .…”

Section: 21mentioning

confidence: 96%

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

Molla

Almenieir

Simoneau³

et al. 2014

Current Oncology

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“…The use of cryoablation in intermediate and advanced HCCs and in unresectable and recurrent tumors has also been reported. Of course, such cases are associated with worse results than in earlier stages and in smaller tumors [28,29].…”

Section: Livermentioning

confidence: 99%

Current Technique and Application of Percutaneous Cryotherapy

Mahnken

König

Figiel

2018

Fortschr Röntgenstr

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ABSTR AC TPurpose Local ablative therapies have become an established treatment option in interventional oncology. Radiofrequency ablation (RFA) and microwave ablation (MWA) are a standard of care in the treatment of hepatocellular carcinoma (HCC). Currently, there is an increasing interest in cryotherapy, one of the oldest ablation techniques. It has some unique characteristics with regard to technology and mechanism of action.Materials and Methods A systematic literature search using the terms cryotherapy, cryosurgery and cryoablation was performed. Selected studies are presented dealing with the mechanism of action, cryobiology and clinical use of percutaneous, image-guided cryoablation. Recent developments and perspectives are presented.Results Cryotherapy is increasingly used and has been included in guidelines for selected tumor entities such as renal cell carcinoma. Cryo-immunotherapy and combination treatments are future areas of interest.Conclusion Cryoabalation may be used in many indications.Its major advantages are its unique visualization and the anesthesiologic effects of cold. While there are only a few prospectively randomized trials, the existing data on the use of cryoablation is promising. Its use appears to be justified in selected tumors, oligometastatic patients and for palliative indications.

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Ultrasound-guided percutaneous cryotherapy of hepatocellular carcinoma

Cited by 45 publications

References 16 publications

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

Current Technique and Application of Percutaneous Cryotherapy

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