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T. S. Ravikumar, MD; Robert Kane, MD; Blake Cady, MD; Roger Jenkins, MD; Melvin Clouse, MD; Glenn Steele, Jr, MD

Arch Surg. 1991;126(12):1520-1524.

Abstract
• This report summarizes our 5-year experience with cryosurgery for in situ ablation of liver tumors. The liver was exposed with laparotomy, and the tumors were subjected to two freeze-thaw cycles using liquid nitrogen delivered by insulated probes; cryoablation was monitored with intraoperative ultrasonography. Tumor markers and computed tomography evaluated tumor response during long-term follow-up. From 1985 to 1990, 32 patients (19 men and 13 women) were entered into this study. The histologic characteristics of the tumors were as follows: colorectal, 24 patients; hepatoma, three patients; neuroendocrine, two patients; and others, three patients. After a follow-up period of 5 to 60 months (median follow-up, 24 months), nine patients (28%) remained disease free, 11 patients (34%) were alive with disease, and 12 patients (38%) died. The patterns of failure included liver and extrahepatic disease in 54% of cases, liver disease only in 32% of cases, and extrahepatic disease only in 14% of cases. In patients with "liver only" failure, recurrence at the treatment site occurred in three patients (9%). This study establishes the long-term effectiveness of cryosurgery in the treatment of primary and metastatic liver tumors.

(Arch Surg. 1991;126:1520-1524)

Author Affiliations
From the Yale University School of Medicine, New Haven, Conn (Dr Ravikumar), and Harvard Medical School, Boston, Mass (Drs Kane, Cady, Jenkins, Clouse, and Steele).

Footnotes
Accepted for publication October 5, 1991.

Presented at the 44th Annual Cancer Symposium of the Society of Surgical Oncology, Orlando, Fla, March 27, 1991.

Reprint requests to the Department of Surgery, Yale University School of Medicine, 333 Cedar St, PO Box 3333, New Haven, CT 06510 (Dr Ravikumar).

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