Cryosurgery for Primary and Metastatic Liver Tumors

Abstract

Cryosurgery is the application of extreme cold temperatures to achieve tumor cell death. Cryoablation, cryotherapy and cryosurgery are interchangeable terms which all apply to the process of tissue destruction using subzero temperatures. Topical application of cold substances to tumors was first reported in treatment of superfiicial tumors of skin, oropharynx and gynecologic systems. (1) The rationale for using extreme cold to treat tumors is the potential for in situ tumor destruction while sparing normal surrounding structures and without the complications of major surgical intervention. In 1963 Irving Cooper was the first to describe the feasibility of such an approach to the liver and other organs. (2) He devised a system of liquid nitrogen delivery through insulated cannulas that could be placed within the substance of the liver. Subsequently Andrew Gage and co-investigators performed in vivo studies of hepatic cryosurgery and described many of the physiologic responses to liver treatment. They showed that large areas of liver could be treated successfully and that large remnants of devitalized tissue did not produce toxic effects to the animal. (3)