Nael El Said Saad MBBCh, Abstract Co-Author: Research Consultant, Veran Medical Technologies, Inc Proctor, Sirtex Medical Ltd

Rebecca J. Mueller MD, Abstract Co-Author: Nothing to Disclose

Kathryn Jane Fowler MD, Abstract Co-Author: Research support, Bracco Group

Joseph Wilson Owen MD, Presenter: Nothing to Disclose

Cryoablation may be used as a means of local tumor control in the liver. Little data is available on hepatic cryoablation. The purpose of our study was to evaluate the safety and outcomes of cryoablation for both primary and metastatic liver tumors in a high volume tertiary care center. 

Retrospective review of all hepatic cryoablation procedures from 10/2006-7/2013. Laboratory data, follow-up imaging, and clinical information were used to determine complications (SIR standards) and outcomes (RECIST). Percutaneous CT guided hepatic cryoablation was performed (1-8 probes based on tumor size and location). Two freeze cycles were performed in 62 of 66 procedures, remainder used three cycles. All patients were admitted overnight for monitoring.  

54 patients underwent 66 ablations (4 cholangiocarcinoma, 1 sarcoma, 1 hemangioendothelioma (HEH), 14 HCC, 32 metastases). Average (range) tumor size was 2.3(0.5-4.5) cm. Follow up ranged (average) 0-45 (17) months. Local tumor progression was seen in 29 patients, the remainder had complete response. The average (median) time to local progression was 207 (148) days. Two patients were lost to follow up. The OS and DFS were not significantly different based on tumor type. 21 complications: 6 major (2 subcapsular hematoma requiring transfusion, 2 pseudoaneurysm requiring embolization, subcutaneous necrosis requiring surgical debridement, hypotension and bradycardia requiring atropine) and 15 minor were identified. Higher number of probes and increased probe:tumor size ratio were associated with cases of bleeding, however, the trend did not reach statistical significance (p 0.61 and p 0.78).  

Hepatic cryoablation can be achieve local tumor control and durable complete response in up to 43% of patients. Complications were seen in approximately 30% of cases with major complications in 9%. Further research is needed to determine the comparative efficacy and ideal role of hepatic cryoablation in the setting of different tumor types. 

Our study evaluates the safety and efficacy experience of hepatic cryoablation for liver tumors in a tertiary care center.  

Saad, N, Mueller, R, Fowler, K, Owen, J, Single Center Experience with Hepatic Cryoablation: Safety and Efficacy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018347.html