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Br J Surg. 2002 Mar;89(3):303-10.

Phase I study of percutaneous cryotherapy for colorectal liver metastasis.

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1
Department of Surgery, Faculty of Medicine, Imperial College of Science, Technology and Medicine, Chelsea, UK. t.allenmarsh@ic.ac.uk

Abstract

BACKGROUND:

The aim was to determine the safety and feasibility of percutaneous cryotherapy for treating irresectable colorectal liver metastases.

METHODS:

Liquid nitrogen cryoprobes were inserted percutaneously into metastases using the Seldinger technique under computed tomographic guidance. Single-probe treatments were performed with either 3.6- or 6.3-mm cryoprobes (ice-ball volumes 18 and 59 cm3 respectively), or dual-probe treatments with two adjacent 6.3-mm probes (ice-ball volume 205 cm3). Treatment involved a single freeze--thaw cycle.

RESULTS:

Fifteen patients received 25 single-probe treatments and seven patients received 14 dual-probe treatments. The treatment-related mortality rate was zero and complications occurred after six of 39 treatments. Liver metastasis growth was significantly delayed for 2 months after dual-probe but not single-probe treatment. Metastasis cryotherapy stimulated an immediate rise, followed by a fall, in serum carcinoembryonic antigen (CEA) level, associated with immune upregulation that was significantly greater after dual-probe treatments.

CONCLUSION:

Ablation zones that were approximately four times larger than those produced by previously described percutaneous techniques delayed the growth of metastases, reduced serum CEA concentration, and induced detectable inflammatory and T-lymphocyte responses. Percutaneous cryotherapy for treatment of colorectal liver metastases is feasible and may have a place in conjunction with chemotherapy.

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