Annals of Surgical Oncology

, Volume 14, Issue 7, pp 2078–2087 | Cite as

Recurrence and Survival Outcomes after Hepatic Resection with or without Cryotherapy for Liver Metastases from Colorectal Carcinoma

  • Rui Niu
  • Tristan D. Yan
  • Jacqui C. Zhu
  • Deborah Black
  • Francis Chu
  • David L. Morris
Hepatic and Pancreatic



Some reports support resection combined with cryotherapy for patients with multiple bilobar colorectal liver metastases (CRLM) that would otherwise be ineligible for curative treatments. This series demonstrates long-term results of 415 patients with CRLM who underwent resection with or without cryotherapy.


Between April 1990 and January 2006, 291 patients were treated with resection only and 124 patients with combined resection and cryotherapy. Recurrence and survival outcomes were compared. Kaplan-Meier and Cox-regression analyses were used to identify significant prognostic indicators for survival.


Median length of follow-up was 25 months (range 1–124 months). The 30-day perioperative mortality rate was 3.1%. Overall median survival was 32 months (range 1–124 months), with 1-, 3- and 5-year survival values of 85%, 45% and 29%, respectively. The overall recurrence rates were 66% and 78% for resection and resection/cryotherapy groups, respectively. For the resection group, the median survival was 34 months, with 1-, 3- and 5- year survival values of 88%, 47% and 32%, respectively. The median survival for the resection/cryotherapy group was 29 months, with 1-, 3- and 5-year survival values of 84%, 43% and 24%, respectively (P = 0.206). Five factors were independently associated with an improved survival: absence of extrahepatic disease at diagnosis, well- or moderately-differentiated colorectal cancer, largest lesion size being 4 cm or less, a postoperative CEA of 5 ng/ml or less and absence of liver recurrence.


Long-term survival results of resection combined with cryotherapy for multiple bilobar CRLM are comparable to that of resection alone in selected patients.


Hepatic cryotherapy Hepatectomy Liver resection Colorectal liver metastases 


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Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • Rui Niu
    • 1
  • Tristan D. Yan
    • 1
  • Jacqui C. Zhu
    • 1
  • Deborah Black
    • 2
  • Francis Chu
    • 1
  • David L. Morris
    • 1
  1. 1.Department of SurgeryUniversity of New South Wales, St George HospitalSydneyAustralia
  2. 2.School of Public Health and Community MedicineSydneyAustralia

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