CRYOSURGERY AS A TREATMENT FOR ADVANCED-STAGE HEPATOCELLULAR-CARCINOMA - RESULTS, COMPLICATIONS, AND ALCOHOL ABLATION

BACKGROUND. The objective of this study was to investigate the use of cryosurgery and to determine whether there is a role for combined ther apy with alcohol ablation in the treatment of patients with hepatocell ular carcinoma. METHODS. Twelve patients with biopsy proven hepatocell ular carcinoma underwent ultrasound-guided cryosurgical ablation of th eir liver rumor. Postoperative alcohol ablation was performed on those patients who were found to have residual tremor or recurrence after t he cryosurgical procedure. RESULTS, Of the 12 patients (9 males, 3 fem ales) the size of the primary tumor ranged from 3-13 cm with average s ize of 7 cm in greatest dimension. Most patients had advanced disease according to the TNM staging system: 9 patients had Stage IVA disease, 2 Stage III, and 1 Stage II. Three patients had residual tumors after the cryosurgical procedure. The residual tumor was treated with alcoh ol ablation. The 1-year survival rate for the entire group was 50% (5 of 10) and the 2-year survival rate was 30% (3 of 10). At last follow- up, I patient with an 8-cm tumor was disease free for 3 years and anot her patient with a 13-cm tumor was disease free for 2.5 years. Both of these patients had Stage IVA disease. CONCLUSIONS, The authors found cryosurgery to be promising in the treatment of this extremely aggress ive form of cancer, with the ability to prolong patient survival. Foll ow-up treatment with alcohol ablation is an important adjunct in treat ing residual tumor and controlling recurrences. (C) 1998 American Canc er Society.