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Cryoablation of malignant liver tumors: results of a single center study |
Wolfgang Jungraithmayr, Dieter Burger, Manfred Olschewski and Stefan Eggstein |
Freiburg, Germany
Author Affiliations: Department of General Surgery (Jungraithmayr W and Eggstein S), Department of Radiology (Burger D), and Department of Medical Biometry and Medical Statistics (Olschewski M), University Hospital of Freiburg, Hugstetter Stra βe 55, 79106 Freiburg, Germany
Corresponding Author: Wolfgang Jungraithmayr, MD, Department of Thoracic Surgery, University Hospital of Freiburg, Hugstetter Straβe 55, 79106 Freiburg, Germany (Tel: +49761-2702457; Fax: +49-761-2702499; Email:jungrait@chir.ukl.Un
i-freiburg.de) |
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Abstract BACKGROUND: Local ablative procedures such as cryosurgery and thermo-ablation are increasingly employed as a supplement to liver resection for the therapy of primary and secondary liver tumors. It is still unclear if the survival time can be extended through local ablative procedures. This prospective study shows operative actions, complications and long-term follow-up of 19 patients undergoing cryotherapy.
METHODS: Between 1997 and 1998, 19 patients underwent cryotherapy due to a non-resectable malignant liver tumor (17 patients with metastases of a colon carcinoma, 2 patients with a hepatocellular carcinoma). Twelve patients (63.2%) received cryotherapy only and seven patients (36.8%) received a combination of resection and cryotherapy. The median follow-up period was 23 months.
RESULTS: In a total of 59 liver tumors (18 were resected and 41 received cryotherapy), 12 had cryotherapy only, and 7 had a combination of cryotherapy and resection. The 30-day lethality was 0%, and the rate of major complications was 21%. After one year, 27.3% of the patients were still recurrence-free. The recurrence rate for all tumors treated was 58.8%. The median survival time for all patients was 21 months. The one-and three-year survival rates were 62.5% and 15.8%, respectively.
CONCLUSIONS: The mortality for cryotherapy is low, but there is a high rate of complications and long-term tumor control is not sufficient. If local ablative procedures of hepatic lesions are to be performed,not laparotomy but percutaneous, percutaneous thermoablation should be discussed as an alternative therapeutic measure.
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