[Cryoablation--a treatment option for inoperable liver tumors?]

Tidsskr Nor Laegeforen. 2001 Sep 10;121(21):2510-5.
[Article in Norwegian]

Abstract

Background: Most patients with primary and secondary liver tumours are inoperable by conventional surgery. This has prompted the development of different techniques of local destruction of liver tumours, i.e. cryosurgical ablation radiofrequency, laser, and microwave ablation.

Material and methods: On the basis of relevant literature and our own experience we describe the principles of local destruction by cryoablation of colorectal metastases.

Results: Indications for ablation are mainly colorectal metastases and hepatocellular carcinoma. Mechanisms for tumour destruction include intra- and extracellular ice crystal formation, cellular membrane rupture, cellular dehydration and ischaemic damage. Ablation is regularly monitored by ultrasonography, which is suboptimal because of inadequate visualisation of the iceball. Long-term outcome of local destruction of liver tumours is not documented and randomized trials are not ethically acceptable. This complicates analyses of patient outcomes.

Interpretation: Local ablation of liver tumours is experimental therapy and should only be performed as a part of prospective trials.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / methods*
  • Colorectal Neoplasms / diagnostic imaging
  • Colorectal Neoplasms / secondary
  • Colorectal Neoplasms / surgery*
  • Cryosurgery / adverse effects
  • Cryosurgery / methods*
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Microwaves / therapeutic use
  • Treatment Outcome
  • Ultrasonography