CRYOSURGERY OF LIVER-CANCER

Cryosurgery, the in situ destruction of tissue using subzero temperatu res, has been used to treat hepatic metastases. Because it is a focal treatment, cryosurgery can be used in patients with unresectable lesio ns due to location (next to major blood vessels) or multiplicity. In t his study, 57 patients with unresectable hepatic metastases were treat ed with cryosurgery (with at least a 6-month follow-up). The number of lesions treated ranged from 1-16 with a mean of 4.6. Forty-three pati ents (73%) had bilobar disease, while 25 patients (42%) were treated w ith a combination of resection and cryosurgery. The disease-free survi val rate (patients with normal computed tomography [CT] scans and carc inoembryonic antigen [CEA] levels) was 27% with a mean follow-up of 21 months. This is comparable to other hepatic cryosurgery studies that have found survival rates of 25-37.5%. Although the results are still short-term, this study indicates that hepatic cryosurgery offers the h ope of long-term survival in patients with unresectable hepatic metast ases. (C) 1993 Wiley-Liss, Inc.