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Repeat hepatic cryotherapy for metastatic colorectal cancer


This study evaluated the risks and benefits of repeat hepatic cryotherapy for recurrent, unresectable hepatic metastases from colorectal carcinoma. Review of a prospective database identified 195 patients who underwent hepatic cryotherapy for metastatic colorectal carcinoma during a 7-year period. Of the 14 patients who underwent successful repeat cryotherapy for recurrences confined to the liver, 86% had Duke’s stage D colorectal carcinoma at initial diagnosis. The median age of the 14 patients was 58 years (range 41 to 77 years). The median number of hepatic metastases was three at the first cryotherapy and two at the second cryotherapy. At a median follow-up of 71 months, the mean survival times from original diagnosis, first cryotherapy, and second cryotherapy were 53,42, and 19 months, respectively. At the most recent follow-up, eight patients (57%) have died of their disease, four (29%) are alive with disease, and two (14%) have no evidence of disease. The mean interval between the first and second cryotherapies was 23 months. The complication rates after the first and second cryotherapies were 7% and 14%, respectively. One patient developed a wound dehiscence after the first cryotherapy. Following the second cryotherapy, one patient had a small bowel obstruction and another had a pleural effusion. There was no perioperative mortality. Repeat cryotherapy for recurrent, unresectable hepadc metastases from colorectal cancer is safe and improves survival. However, a prospective trial is needed to validate the efficacy of systemic therapy and to better define the indications for repeat hepatic cryotherapy.

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  1. 1.

    Pinson C, Wright J, Chapman W, Garrard C, Blair T, Sawyers J. Repeat hepatic surgery for colorectal cancer metastatic to the liver. Ann Surg 1996;223:765–776.

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Fong Y, Blumgart L, Cohen A, Fortner J, Brennan M. Repeat hepatic resection for metastatic colorectal cancer. Ann Surg 1994;220:657–662.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Korpan N.. Hepatic cryosurgery for liver metastases. Longterm follow-up. Ann Surg 1997;225:193–201.

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Dale P, Souza J, Brewer D. Cryosurgical ablation of unresectable hepatic metastases. J Surg Oncol 1998;68:242–245.

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Stone M, Cady B, Jenkins R, McDermott W, Steele G. Surgical therapy for recurrent liver metastases from colorectal cancer. Arch Surg 1990;125:718–722.

    PubMed  CAS  Google Scholar 

  6. 6.

    Steele G, Osteen R, Wilson R, Brooks D, Mayer R, Zamcheck N, Ravikumar T. Patterns of failure after surgical cure of large liver tumors. AmJ Surg 1984;147:554–559.

    Article  Google Scholar 

  7. 7.

    Griffith K, Sugarbaker P, Chang A. Repeat hepatic resections for colorectal metastases. Surgery 1990;107:101–104.

    PubMed  CAS  Google Scholar 

  8. 8.

    Bozzetti F, Bignami P, Montalto F, Doci R, Gennari L. Repeated hepadc resection for recurrent metastases from colorectal cancer. Br J Surg 1992;79:146–148.

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Kin T, Nakajima Y, Kanehiro H, Hisanage M, Ohyama T, Nishio K, Sho M, Nagao M, Nakano H. Repeat hepatectomy for recurrent colorectal metastases. World J Surg 1998;22:1087–1091.

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Tandan VR, Harmantas A, Gallinger S. Long-term survival after hepatic cryosurgery versus surgical resection for metastatic colorectal carcinoma: A critical review of the literature. CanJ Surg 1997;40:175–181.

    CAS  Google Scholar 

  11. 11.

    Seifert J, Morris D. Repeat hepatic cryotherapy for recurrent metastases from colorectal cancer. Surgery 1999;125:233–235.

    PubMed  CAS  Google Scholar 

  12. 12.

    Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics, 2000. CA Cancer J Clin 2000;50:7–33.

    PubMed  CAS  Article  Google Scholar 

  13. 13.

    Elias D, Lasser P, HoangJ, Leclere J, Debaene B, Bognel C, Spencer A, Rougier P. Repeat hepatectomy for cancer. Br J Surg 1993;80:1557–1562.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Lange J, Leese T, Castaing D, Bismuth H. Repeat hepatectomy for recurrent malignant tumors of the liver. Surg Gynecol Obstet 1989;169:119–126.

    PubMed  CAS  Google Scholar 

  15. 15.

    Former J. Recurrence of colorectal cancer after hepatic resection. AmJ Surg 1988;155:378–382.

    Article  Google Scholar 

  16. 16.

    Adson M. Resection of liver metastases—when is it worth while? World J Surg 1987; ll:5ll-520.

    Google Scholar 

  17. 17.

    Jaffe B, Donegan W, Watson F, Spratt J. Factors influencing survival in paGents with untreated hepatic metastases. Surg Gynecol Obstet 1968; 127:1–11.

    PubMed  CAS  Google Scholar 

  18. 18.

    Wood C, Gillis C. Blumgart L. A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Oncol 1976;2:285–288.

    PubMed  CAS  Google Scholar 

  19. 19.

    Seifert J, Morris D. Prognostic factors after cryotherapy for hepatic metastases from colorectal cancer. Ann Surg 1998;228:201–208.

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Kemeny N, Daly J, Reichman B, Geller N, Botet J, Oderman P Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma. A randomized trial. Ann Intern Med 1987; 107:459–465.

    PubMed  CAS  Google Scholar 

  21. 21.

    Patt Y, Mavligit G. Arterial chemotherapy in the management of colorectal cancer. An overview. Semin Oncol 1991;18:478–490.

    PubMed  CAS  Google Scholar 

  22. 22.

    Weaver M, Ashton J, Zemel R. Treatment of colorectal liver metastases by cryotherapy. Semin Surg Oncol 1998;14:163–170.

    PubMed  Article  CAS  Google Scholar 

  23. 23.

    Rossi S, Di Stasi M, Buscarini E, Cavanna L, Quaretti P, Squassante E, Garbagnati F, Buscarini L. Percutaneous radiofrequency interstitial thermal ablation in the treatment of small hepatocellular carcinoma. Cancer J Sci Am 1995; 1:73–81.

    PubMed  CAS  Google Scholar 

  24. 24.

    Siperstein A, Rogers S, Hansen P, Gitomirsky A. Laparoscopic thermal ablation of hepatic neuroendocrine metastases. Surgery 1997;122:1147–1155.

    PubMed  Article  CAS  Google Scholar 

  25. 25.

    Curley S, Izzo F, Delrio P, Ellis L, Granchi J, Vallone P, Fiore F, Pignata S, Daniele B, Cremona F. Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies. Ann Surg 1999;230:1–8.

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Bilchik A, Rose D, Allegra D, Bostick P, Hsueh E, Morton D. Radiofrequency ablation: A minimally invasive technique with multiple applications. Cancer J Sci Am 1999;5:356–361.

    PubMed  CAS  Google Scholar 

  27. 27.

    Bilchik A, Wood T, Allegra D, Tsioulias G, Chung M, Rose D, Ramming K, Morton D. Cryosurgical ablation and radiofrequency ablation for unresectable hepatic malignant neoplasms—a proposed algorithm. Arch Surg 2000;135:657–664.

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Mathew H. Chung M.D..

Additional information

Supported in part by grant T32 CA 09689 from the National Cancer Institute and by funding from the Rogovin-Davidow Foundation, Los Angeles, Calif.

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Chung, M.H., Ye, W., Ramming, K.P. et al. Repeat hepatic cryotherapy for metastatic colorectal cancer. J Gastrointest Surg 5, 287–293 (2001).

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Key words

  • Cryotherapy
  • hepatic metastasis
  • colorectal cancer
  • recurrence