Cryosurgery in the Treatment of Hepatocellular Carcinoma
Dr. Edip AKPINAR, Dr. Rene ADAM, Dr. Marc JOHANN, Dr. Francis KUNSTLINGER, Dr. Henri BISMUTH
Hepato-Biliyer Cerrahi Merkezi, Paul Brousse Hastanesi ve Güney Paris Üniversitesi Tıp Fakültesi, Villejuif, FRANSA
Abstract
Because of the ill location of tumor nodules and/or the limited function of the liver in cirrhotics, only 10-15% of patients with hepatocellular carcinoma (HCC) are amenable to resection. Some new modalities such as cryosurgery may offer new treatment alternatives to patients with unresectable HCC.
Cryosurgery was used in the treatment of 16 patients. Five patients were treated by cryo-alone, 6 patients were cryotreated combined to resection and 5 patients were cyrotreated by targeting the resection margin after the resection as an adjunct. AFP decrease was noted in all patients with previously high AFP levels and tumor mass control was achieved in all patients. In 21 months (3-29) of mean follow up period 4 patients recurred and 3 of these died. The cumulative survival at 12th and 24th month were 86% and 78% respectively.
Cryosurgery provides an effective tumor control and long survival in patients with unresectable HCC and widens the resectabilility criteria.
Keywords: Cryosurgery, Hepatocellular carcinoma