CYTOABLATIVE THERAPY WITH COMBINED RESECTION AND CRYOSURGERY FOR LIMITED BILOBAR HEPATIC COLORECTAL METASTASES

BACKGROUND: Cryosurgery can be employed in patients with unresectable hepatic metastases when the tumor size and the number of metastases ar e limited. However, local recurrence can result from incomplete ablati on. We proposed a trial of complete cytoablation with a combined appro ach of cryosurgery and hepatic resection for patients with bilobar hep atic metastases. METHODS: Seven patients underwent cryosurgery alone ( CRYO). Seven additional patients underwent combined resection and cryo surgery (CRYO+RES) for bilobar metastases. RESULTS: In the CRYO group, 5 of 7 patients had at least one centrally located tumor. All 5 of th ese patients had early recurrence at the site of ablation. In the CRYO +RES group complete ablation was achieved in 7 of 7. Two (28.6%) of th ese patients developed local recurrence. CONCLUSION: Cytoablation of h epatic metastases can be safely achieved with combined hepatic resecti on and cryosurgery in selected patients. Long-term survival data are n ecessary before advocating widespread application of this approach. (C ) 1997 By Excerpta Medica, Inc.