HYPOTHESIS: The complication and success rates in patients treated with either percutaneous cryosurgery (PCS) or percutaneous radiofrequency (PRF) for unresectable hepatic malignancies are similar. DESIGN: Retrospective study. SETTING: University hospital. PATIENTS AND METHODS: Sixty-four patients were treated with either PCS (n = 31) or PRF (n = 33). Patient treatment was based on the random availability of the probes. Tumors were evaluated by a blinded comparison of pretreatment and posttreatment helical computed tomographic scans. All living patients had at least a 6-month follow-up. MAIN OUTCOME MEASURES: Complication rate, initial treatment success (complete devascularization of the tumor), and local recurrence (tumor revascularization within or at its periphery). RESULTS: The distribution of tumor types was similar in the 2 groups (P =.76). One patient with cirrhosis died of variceal hemorrhage on day 30 after PCS (mortality, 3.2%), while no mortality was observed after PRF (P =.48). Complications occurred in 9 (29%) of the patients following PCS and in 8 (24%) of the patients following PRF (P =.66). Initial treatment success was comparable in the 2 treatment groups (30 [83%] of 36 tumors following PCS vs 34 [83%] of 41 tumors following PRF). However, local recurrences occurred more frequently after PCS than after PRF (16 [53%] of 30 vs 6 [18%] of 34; P =.003). The higher rate of local recurrence was identified for metastases (10 [71%] of 14 after PCS vs 3 [19%] of 16 after PRF; P =.004), while the difference was not significant for hepatocellular carcinoma (6 [38%] of 16 after PCS vs 3 [17%] of 18 after PRF; P =.25). Multivariate analysis demonstrated that the use of PCS (P =.003) and more than 1 treatment (P =.05) were independent risk factors for local tumor recurrence. CONCLUSION: While similar initial treatment success and complication rates are observed following either PCS or PRF, local recurrences occur more frequently following PCS, particularly for metastases.
HYPOTHESIS: The complication and success rates in patients treated with either percutaneous cryosurgery (PCS) or percutaneous radiofrequency (PRF) for unresectable hepatic malignancies are similar. DESIGN: Retrospective study. SETTING: University hospital. PATIENTS AND METHODS: Sixty-four patients were treated with either PCS (n = 31) or PRF (n = 33). Patient treatment was based on the random availability of the probes. Tumors were evaluated by a blinded comparison of pretreatment and posttreatment helical computed tomographic scans. All living patients had at least a 6-month follow-up. MAIN OUTCOME MEASURES: Complication rate, initial treatment success (complete devascularization of the tumor), and local recurrence (tumor revascularization within or at its periphery). RESULTS: The distribution of tumor types was similar in the 2 groups (P =.76). One patient with cirrhosis died of variceal hemorrhage on day 30 after PCS (mortality, 3.2%), while no mortality was observed after PRF (P =.48). Complications occurred in 9 (29%) of the patients following PCS and in 8 (24%) of the patients following PRF (P =.66). Initial treatment success was comparable in the 2 treatment groups (30 [83%] of 36 tumors following PCS vs 34 [83%] of 41 tumors following PRF). However, local recurrences occurred more frequently after PCS than after PRF (16 [53%] of 30 vs 6 [18%] of 34; P =.003). The higher rate of local recurrence was identified for metastases (10 [71%] of 14 after PCS vs 3 [19%] of 16 after PRF; P =.004), while the difference was not significant for hepatocellular carcinoma (6 [38%] of 16 after PCS vs 3 [17%] of 18 after PRF; P =.25). Multivariate analysis demonstrated that the use of PCS (P =.003) and more than 1 treatment (P =.05) were independent risk factors for local tumor recurrence. CONCLUSION: While similar initial treatment success and complication rates are observed following either PCS or PRF, local recurrences occur more frequently following PCS, particularly for metastases.
Authors: Michael J Ryan; Jonathon Willatt; Bill S Majdalany; Ania Z Kielar; Suzanne Chong; Julie A Ruma; Amit Pandya Journal: World J Hepatol Date: 2016-01-28
Authors: Daniel I Glazer; Servet Tatli; Paul B Shyn; Mark G Vangel; Kemal Tuncali; Stuart G Silverman Journal: AJR Am J Roentgenol Date: 2017-09-27 Impact factor: 3.959
Authors: Bertrand Janne d'Othée; Constantinos T Sofocleous; Nader Hanna; Robert J Lewandowski; Michael C Soulen; Jean-Nicolas Vauthey; Steven J Cohen; Alan P Venook; Matthew S Johnson; Andrew S Kennedy; Ravi Murthy; Jean-Francois Geschwind; Stephen T Kee Journal: J Vasc Interv Radiol Date: 2012-02 Impact factor: 3.464