Ultrasound-guided hepatic cryosurgery in the treatment of metastatic colon carcinoma: preliminary results

Article Abstract:

In the United States each year, about 150,000 cases of colorectal cancer are diagnosed and over 60,000 individuals die of this disease. A significant portion of these patients die from metastases to the liver, the preferred location for metastasis by colorectal cancer cells. This is presumably due, in large part, to the portal circulation, which carries blood from the intestines directly into the liver. The only treatment for liver metastases to achieve any sort of success is surgery, which can offer a long-term disease-free survival rate of about 30 percent. However, this is the case for only about 25 percent of patients whose disease is amenable to surgical treatment. If the patient has multiple metastases in several lobes of the liver, or if the metastases are close to import blood vessels, then surgery may not be possible. One approach to this problem is the application of cryosurgery. In this technique, cancerous tissue is penetrated by a probe which is then reduced in temperature past the freezing point of the surrounding tissue. The stress of freezing then destroys the cancerous tissue. This technique causes less harm for normal tissues than does conventional surgery, and may be used for cases in which conventional surgery is not practical. While cryosurgery has been around for some time, recent developments in ultrasound imaging confer new usefulness on the technique. Obviously, the cryoprobe must be inserted into the cancer with accuracy for the method to be successful, and this accuracy is exactly what ultrasound imaging can provide. Eighteen patients with colorectal cancer whose liver metastases were not treatable by conventional surgery were treated with ultrasonic-guided cryosurgery. The number of metastatic cancers in each patient ranged from 1 to 12 with a median of 6. In four patients the cryosurgery was not successful. Of the remaining 14 patients, 4 remain in complete remission with an average follow-up of 28.8 months. For the 14 patients with recurrent disease (including those with unsuccessful cryosurgery), the median survival was 21.4 months and only 2 remain alive. The results indicate that cryosurgery guided by ultrasound imaging shows promise for the treatment of metastatic liver cancer that is not amenable to conventional surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Colorectal cancer, Cancer invasiveness, Cancer metastasis, Liver cancer, Cryosurgery

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Occult papillary carcinoma of the thyroid: a study of 408 autopsy cases

Article Abstract:

Clinically evident thyroid cancer has an annual incidence in Japan of roughly 0.5 per 100,000 men and 1.9 to 3.0 per 100,000 women. It is somewhat surprising, therefore, that tiny thyroid cancers may be found in as many as one third of all individuals examined at autopsy. The frequency of occult thyroid cancer has been reported to be from 5.6 percent to 35.6 percent when thyroids are examined at autopsy. In a recent study of 408 consecutive autopsy cases, 46 cases of thyroid cancer were observed, for a prevalence of 11.3 percent. The thyroid cancers were of the histological type called occult papillary carcinoma. Although the natural history of these cancers is uncertain, pathological studies permit a plausible picture to be pieced together. The initial cancer is quite small, less than a few millimeters. As the cancer grows, fibrosis sets in, and some inflammatory reaction occurs. The inflammatory reaction apparently kills the cancer cells, leaving only a fibrous capsule behind. It is interesting to note that there were no differences observed between the sexes in the incidence of occult papillary carcinomas. Since clinical thyroid cancers are at least six times more common among women than men, this suggests that some characteristic of women promotes the development of these occult cancers in women, or, conversely, some male characteristic suppresses the process. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Cancer, Thyroid cancer

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