 |
|
A Comparison of Percutaneous Cryosurgery and Percutaneous Radiofrequency for Unresectable Hepatic Malignancies
René Adam, MD,PhD;
Ellen J. Hagopian, MD;
Marcelo Linhares, MD;
Jinane Krissat, MD;
Eric Savier, MD;
Daniel Azoulay, MD,PhD;
Francis Kunstlinger, MD;
Denis Castaing, MD;
Henri Bismuth, MD
Arch Surg. 2002;137:1332-1339.
Hypothesis The complication and success rates in patients treated with either percutaneous cryosurgery (PCS) or percutaneous radiofrequency (PRF) for unresectable hepatic malignancies are similar.
Design Retrospective study.
Setting University hospital.
Patients and Methods Sixty-four patients were treated with either PCS (n = 31) or PRF (n = 33). Patient treatment was based on the random availability of the probes. Tumors were evaluated by a blinded comparison of pretreatment and posttreatment helical computed tomographic scans. All living patients had at least a 6-month follow-up.
Main Outcome Measures Complication rate, initial treatment success (complete devascularization of the tumor), and local recurrence (tumor revascularization within or at its periphery).
Results The distribution of tumor types was similar in the 2 groups (P = .76). One patient with cirrhosis died of variceal hemorrhage on day 30 after PCS (mortality, 3.2%), while no mortality was observed after PRF (P = .48). Complications occurred in 9 (29%) of the patients following PCS and in 8 (24%) of the patients following PRF (P = .66). Initial treatment success was comparable in the 2 treatment groups (30 [83%] of 36 tumors following PCS vs 34 [83%] of 41 tumors following PRF). However, local recurrences occurred more frequently after PCS than after PRF (16 [53%] of 30 vs 6 [18%] of 34; P = .003). The higher rate of local recurrence was identified for metastases (10 [71%] of 14 after PCS vs 3 [19%] of 16 after PRF; P = .004), while the difference was not significant for hepatocellular carcinoma (6 [38%] of 16 after PCS vs 3 [17%] of 18 after PRF; P = .25). Multivariate analysis demonstrated that the use of PCS (P = .003) and more than 1 treatment (P = .05) were independent risk factors for local tumor recurrence.
Conclusion While similar initial treatment success and complication rates are observed following either PCS or PRF, local recurrences occur more frequently following PCS, particularly for metastases.
From the Department of Hepatobiliary Surgery and Liver Transplantation, Centre Hepato-Biliaire, Hôpital Paul Brousse, Université Paris Sud, Villejuif, France.
RELATED ARTICLES
This Month in Archives of Surgery
Arch Surg. 2002;137(12):1330.
FULL TEXT
A Comparison of Percutaneous Cryosurgery and Percutaneous Radiofrequency for Unresectable Hepatic Malignancies—Invited Critique
Jack Pickleman
Arch Surg. 2002;137(12):1340.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Liver Resection With a New Multiprobe Bipolar Radiofrequency Device
Ayav et al.
Arch Surg 2008;143:396-401.
ABSTRACT
| FULL TEXT
Comparison Between Local Ablative Therapy and Chemotherapy for Non-Resectable Colorectal Liver Metastases: A Prospective Study
Ruers et al.
Ann. Surg. Oncol. 2007;14:1161-1169.
ABSTRACT
| FULL TEXT
Guidelines for resection of colorectal cancer liver metastases
Garden et al.
Gut 2006;55:iii1-iii8.
FULL TEXT
The End of Cryotherapy for the Treatment of Nonresectable Hepatic Tumors?
Sheen and Siriwardena
Ann. Surg. Oncol. 2005;12:202-204.
FULL TEXT
Ablative Therapy for Liver Cancer: Which?
Morris
Ann. Surg. Oncol. 2005;12:205-206.
FULL TEXT
Current techniques and results of liver resection for colorectal liver metastases
Hamady et al.
Br Med Bull 2004;70:87-104.
ABSTRACT
| FULL TEXT
Liver ablation therapy
Gillams
Br. J. Radiol. 2004;77:713-723.
FULL TEXT
Percutaneous Radiofrequency Ablation of Lung Tumors with Expandable Needle Electrodes: Tips from Preliminary Experience
Steinke et al.
Am. J. Roentgenol. 2004;183:605-611.
FULL TEXT
Comparison of Systemic Responses of Radiofrequency Ablation, Cryotherapy, and Surgical Resection in a Porcine Liver Model
Ng et al.
Ann. Surg. Oncol. 2004;11:650-657.
ABSTRACT
| FULL TEXT
Cryotherapy and Percutaneous Ablation
Shapiro et al.
Am. J. Roentgenol. 2004;182:1597-1597.
FULL TEXT
Stereotactic Body Radiation Therapy: An Ablative Treatment Option for Primary and Secondary Liver Tumors
Fuss and Thomas
Ann. Surg. Oncol. 2004;11:130-138.
ABSTRACT
| FULL TEXT
Percutaneous Ablation of Liver Tumors
Boyle
Arch Surg 2003;138:809-809.
FULL TEXT
|
