BUFFALO, NY--Renewed interest in cryosurgery may soon translate
into a viable therapeutic option for patients with primary and
secondary liver cancers.
"The field of hepatic cryosurgery is wide open for original
research," Miguel Rodriguez-Bigas, MD, said at a conference
on multidisciplinary cancer care sponsored by the Roswell Park
Cancer Institute, where he is a surgical oncol-ogist. The conference
was supported by an unrestricted educational grant from Bristol-Myers
Important research may emerge from the Hepatic Cryosurgery Center,
recently established by Roswell Park's Division of Surgical Oncology,
under the direction of Nicholas J. Petrelli, MD.
The Center, Dr. Rodriguez-Bigas said, will offer "innovative
treatment regimens for unresectable hepatocellular carcinomas
and metastatic neoplasms from soft tissue sarcomas, neuroendocrine
tumors, and colorectal cancer."
He also suggested that cryosurgery may be beneficial in palliating
systemic symptoms caused by unresectable, hormonally active hepatic
metastases. "There is an immunological response to hepatic
cryosurgery," he noted, "that has yet to be characterized."
Because the amount of normal tissue frozen can be controlled,
tumors in multiple hepatic segments can be treated and, on occasion,
re-treated if they recur. The most common side effects--elevations
in liver function tests, fever, and throm-bocytopenia--are usually
transient, Dr. Rodriguez-Bigas said.
Roswell Park's current cryosurgical studies are assessing outcome
and tumor response, and will clarify some of the treatment "unknowns,"
including identifying the best candidates.