Resection with cryotherapy of colorectal hepatic metastases has the same survival as hepatic resection alone

Background: Hepatic resection is well established as a potentially curative treatment for hepatic colorectal cancer metastases. However, only a small proportion of patients with liver metastases are suitable for resection bec ause they either have extrahepatic disease, or the extent and/or the distri bution of their hepatic disease would make excision impossible. We have pre viously described the use of cryotherapy for inadequate resection margins a nd lesions in the remaining lobe of the liver. Combining such cryodestructi ve techniques with resection offers the possibility of increasing the propo rtion of patients to whom potentially curative treatment can be offered. Th e aim of this study was to compare survival in patients treated with resect ion and cryotherapy against those of patients treated with resection alone. Potential prognostic variables were also examined. Method: Patients undergoing a hepatic resection with or without cryotherapy at our unit between April 1990 and July 1997 were identified from our data base and their notes reviewed. Survival was estimated using the Kaplan-Meie r method and compared using the Log rank test. Results: One hundred and seven patients were treated in total: 32 underwent resection alone, and 75 underwent resection combined with cryotherapy. The re was no significant difference between the survival of patients treated w ith resection alone and those treated with resection and cryotherapy. Conclusions: Edge and contralobe cryotherapy can be combined with hepatic r esection to allow a greater proportion of patients with hepatic colorectal metastases to be offered treatment, and results in similar survival figures comparable to hepatic resection for at least 3 years.