Review Article

Evolving Ablative Therapies for Hepatic Malignancy

Table 3

Summary of studies with cryoablation in patients with primary and metastatic liver malignancy.

Author(s)YearType of studySummary and outcome(s)

Niu et al. [21]2007Case seriesAim: to evaluate long-term outcomes in patients treated with CA for multiple bilobar CRLM
Study data: 415 patients; 291 patients treated with HR and 124 treated with HR + CA
Conclusions: median OS 32 moths, 5-year survival with HR and HR + CA were 32% and 24%, respectively ( ); overall, long-term survival results of HR + CA for multiple bilobar CRLM are comparable to that of HR alone in selected patients

Zhou and Tang [33]1998Case seriesAim: to evaluate the effects of CA with and without other treatments in HCC
Study data: 235 patients; 78 patients treated with CA, 58 patients with CA + HALP, 27 patients treated with CA + surgical resection, and 72 patients treated with CA followed by resection of the frozen tumor
Conclusions: CA is as effective as other treatments for treating patients with HCC

Wren et al. [34]1997Case seriesAim: to evaluate the efficacy of CA in patients with cirrhosis and unresectable HCC
Study data: 12 patients (stage II, 2; stage III, 1; stage IVA, 7; stage IVB, 2)
Conclusions: CA is feasible and safe and is primarily palliative; it may provide cure in selected patients with lower-stage disease

Haddad et al. [35]1998Case seriesAim: to evaluate effects of CA and surgical resection for advanced hepatic tumors
Study data: 31 patients
Conclusions: CA complements surgical resection but can cause significant morbidity especially in patients with advanced unresectable hepatobiliary tumors

Seifert et al. [36]2005Case control studyAim: to compare morbidity, mortality, recurrence, and survival between CA and liver resection in patients with liver metastases
Study data: 223 patients; 168 patients underwent liver resection and 55 patients had CA
Conclusions: survival is comparable in selected patients; however, CA is associated with higher rates of hepatic recurrence; CA may not be suitable for patients with resectable disease

Xu et al. [37]2008Case seriesAim: to evaluate the safety and efficacy of CA in patients with hepatic colorectal metastases
Study data: 326 patients treated with CA for unresectable metastatic lesions
Conclusions: CA is safe and complements surgical resection in unresectable tumors

Seifert and Morris [38]1999Survey analysisAim: to evaluate incidence, morbidity, and mortality during treatment with CA
Study data: 134 centers worldwide (44.8% response); 7605 patients; 2173 patients were treated with hepatic CA
Conclusions: serious complication like cryoshock develops in 1% of all patients with hepatic CA; cryoshock is responsible for 18.2% of all deaths associated with this treatment

Jungraithmayr et al. [39]2005Case seriesAim: to evaluate the effects of CA in patients with primary and secondary liver malignancy
Study data: 54 lesions; 19 patients; 17 patients with metastasis, 2 with HCC
Conclusions: CA results in high rate of complications and poor long-term tumor control

CA: cryotherapy; HALP: hepatic artery ligation and perfusion; HR: hepatic resection; HCC: hepatocellular carcinoma.