Percutaneous comprehensive cryoablation for metastatic hepatocellular cancer

Percutaneous ablation is the currently preferred locoregional therapy for non-resectable hepatocellular cancer (HCC). Cryoablation is an attractive option because it forms an ice ball viewable by many imaging methods. This study assessed the therapeutic effect of comprehensive cryoablation (of intra- and extrahepatic tumors) in patients with metastatic HCC. Forty-five patients met the inclusion criteria from January, 2004 to October, 2011. Treatment was performed on 33 patients; 12 patients received no treatment. Procedural safety and overall survival (OS) were assessed according to metastatic stage. The OS of patients who received comprehensive treatment was significantly longer than that of those who received no treatment (median: 26 vs. 3.5 months, P < 0.001). Large (⩾5 cm long diameter) hepatic tumors were treated in advance with transarterial chemoembolization, but the OS of patients in the same metastatic stage was similar (P = 0.0677). In the comprehensive cryoablation group, timely treatment (within 2 months after diagnosis of metastatic HCC) was associated with a longer OS than when treatment was delayed for 3-7 months (median: 38.5 vs. 21 months, P = 0.0167). Multiple treatments improved the survival of patients who received comprehensive treatment (P = 0.0489). In terms of increasing the survival time of metastatic HCC patients, the effect of comprehensive cryosurgery was significant. Timely or multiple treatments had greater therapeutic effects than delayed or single treatment.