Current Technique and Application of Percutaneous Cryotherapy

Abstract

ABSTR AC TPurpose Local ablative therapies have become an established treatment option in interventional oncology. Radiofrequency ablation (RFA) and microwave ablation (MWA) are a standard of care in the treatment of hepatocellular carcinoma (HCC). Currently, there is an increasing interest in cryotherapy, one of the oldest ablation techniques. It has some unique characteristics with regard to technology and mechanism of action.Materials and Methods A systematic literature search using the terms cryotherapy, cryosurgery and cryoablation was performed. Selected studies are presented dealing with the mechanism of action, cryobiology and clinical use of percutaneous, image-guided cryoablation. Recent developments and perspectives are presented.Results Cryotherapy is increasingly used and has been included in guidelines for selected tumor entities such as renal cell carcinoma. Cryo-immunotherapy and combination treatments are future areas of interest.Conclusion Cryoabalation may be used in many indications.Its major advantages are its unique visualization and the anesthesiologic effects of cold. While there are only a few prospectively randomized trials, the existing data on the use of cryoablation is promising. Its use appears to be justified in selected tumors, oligometastatic patients and for palliative indications.

Comparing cryoablation and microwave ablation for the treatment of patients with stage�IIIB/IV non‑small cell lung cancer

“…MWA and CA have received increasing attention in recent years for treating malignancies of the lung (6,28,32). However, whether MWA or CA should be used in specific patients remains unclear.…”

“…Survival analysis of sub-groups. Tumor size has been reported as a prognostic marker of disease progression in a number of previous studies (2,16,25,(28)(29)(30)(31)(32). Therefore, the survival function of patients treated with MWA and CA were analyzed according to tumor size.…”

<p>Cryoablation In The Management Of Breast Cancer: Evidence To Date</p>

“…The efficacy of cryoablation is based on the cytotoxic effects of cold that produce both instant and delayed destruction of cellular ultrastructure. Tissue destruction occurs when tissues are frozen to lethal temperatures lower than −40°C 3,10–12. Cold temperatures result in increasing of intracellular osmolarity and freezing of extracellular water; this causes, in turn, drawing water out of the cells and cellular dehydration.…”

“…Ablation techniques offer the advantage of being done percutaneously under image guidance, thus obtaining in general low rates of complications and patients’ discomfort. As regards breast cancer, a large amount of articles in the recent literature reports on the use of radiofrequency, microwave ablation, cryoablation, interstitial laser therapy, and focused ultrasound in different clinical scenarios 3,6–9. Among them, cryoablation represents an emerging treatment, which has been used in the treatment of both benign and malignant breast diseases.…”

Benign Breast Tumours - Diagnosis and Management

“…When compared with VAB, it was not possible to detect any recurrences. The analgesic effect of the cold, the procedure-related lack of any changes being discernible on mammographic examination conducted at a later date, and the positive immunostimulatory effect are all deemed to be beneficial [59,60,61,62]. …”