RSS-Feed abonnieren
DOI: 10.1055/s-0043-1777845
Thermal Ablation in the Liver: Heat versus Cold—What Is the Role of Cryoablation?
![](https://www.thieme-connect.de/media/sir/202306/lookinside/thumbnails/10-1055-s-0043-1777845_001522-1.jpg)
Abstract
Cryoablation is commonly used in the kidney, lung, breast, and soft tissue, but is an uncommon choice in the liver where radiofrequency ablation (RFA) and microwave ablation (MWA) predominate. This is in part for historical reasons due to serious complications that occurred with open hepatic cryoablation using early technology. More current technology combined with image-guided percutaneous approaches has ameliorated these issues and allowed cryoablation to become a safe and effective thermal ablation modality for treating liver tumors. Cryoablation has several advantages over RFA and MWA including the ability to visualize the ice ball, minimal procedural pain, and strong immunomodulatory effects. This article will review the current literature on cryoablation of primary and secondary liver tumors, with a focus on efficacy, safety, and immunogenic potential. Clinical scenarios when it may be more beneficial to use cryoablation over heat-based ablation in the liver, as well as directions for future research, will also be discussed.
Keywords
cryoablation - radiofrequency ablation - microwave ablation - hepatocellular carcinoma - liver metastases - interventional radiologyPublikationsverlauf
Artikel online veröffentlicht:
24. Januar 2024
© 2023. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Ozen M, Raissi D. Current perspectives on microwave ablation of liver lesions in difficult locations. J Clin Imaging Sci 2022; 12: 61
- 2 Ozen M, Raissi D. Editorial comment: a review on radiofrequency, microwave and high-intensity focused ultrasound ablations for hepatocellular carcinoma with cirrhosis. Hepatobiliary Surg Nutr 2022; 11 (03) 453-456
- 3 Tait IS, Yong SM, Cuschieri SA. Laparoscopic in situ ablation of liver cancer with cryotherapy and radiofrequency ablation. Br J Surg 2002; 89 (12) 1613-1619
- 4 Bilchik AJ, Wood TF, Allegra D. et al. Cryosurgical ablation and radiofrequency ablation for unresectable hepatic malignant neoplasms: a proposed algorithm. Arch Surg 2000; 135 (06) 657-662 , discussion 662–664
- 5 Adam R, Hagopian EJ, Linhares M. et al. A comparison of percutaneous cryosurgery and percutaneous radiofrequency for unresectable hepatic malignancies. Arch Surg 2002; 137 (12) 1332-1339 , discussion 1340
- 6 Seifert JK, Morris DL. World survey on the complications of hepatic and prostate cryotherapy. World J Surg 1999; 23 (02) 109-113 , discussion 113–114
- 7 Huang YZ, Zhou SC, Zhou H, Tong M. Radiofrequency ablation versus cryosurgery ablation for hepatocellular carcinoma: a meta-analysis. Hepatogastroenterology 2013; 60 (125) 1131-1135
- 8 Gupta P, Maralakunte M, Kumar-M P. et al. Overall survival and local recurrence following RFA, MWA, and cryoablation of very early and early HCC: a systematic review and Bayesian network meta-analysis. Eur Radiol 2021; 31 (07) 5400-5408
- 9 Song KD. Percutaneous cryoablation for hepatocellular carcinoma. Clin Mol Hepatol 2016; 22 (04) 509-515
- 10 Glazer DI, Tatli S, Shyn PB, Vangel MG, Tuncali K, Silverman SG. Percutaneous image-guided cryoablation of hepatic tumors: single-center experience with intermediate to long-term outcomes. AJR Am J Roentgenol 2017; 209 (06) 1381-1389
- 11 Kim DK, Han K, Won JY, Kim GM, Kwon JH, Kim MD. Percutaneous cryoablation in early stage hepatocellular carcinoma: analysis of local tumor progression factors. Diagn Interv Radiol 2020; 26 (02) 111-117
- 12 Ko SE, Lee MW, Rhim H. et al. Comparison of procedure-related complications between percutaneous cryoablation and radiofrequency ablation for treating periductal hepatocellular carcinoma. Int J Hyperthermia 2020; 37 (01) 1354-1361
- 13 Ma J, Wang F, Zhang W. et al. Percutaneous cryoablation for the treatment of liver cancer at special sites: an assessment of efficacy and safety. Quant Imaging Med Surg 2019; 9 (12) 1948-1957
- 14 Yakkala C, Chiang CLL, Kandalaft L, Denys A, Duran R. Cryoablation and immunotherapy: an enthralling synergy to confront the tumors. Front Immunol 2019; 10: 2283
- 15 Mandt T, Bangar A, Sauceda C. et al. Stimulating antitumoral immunity by percutaneous cryoablation and combination immunoadjuvant therapy in a murine model of hepatocellular carcinoma. J Vasc Interv Radiol 2023; 34 (09) 1516-1527.e6
- 16 Shen L, Qi H, Chen S. et al. Cryoablation combined with transarterial infusion of pembrolizumab (CATAP) for liver metastases of melanoma: an ambispective, proof-of-concept cohort study. Cancer Immunol Immunother 2020; 69 (09) 1713-1724
- 17 Littrup PJ, Aoun HD, Adam B, Krycia M, Prus M, Shields A. Percutaneous cryoablation of hepatic tumors: long-term experience of a large U.S. series. Abdom Radiol (NY) 2016; 41 (04) 767-780
- 18 Pusceddu C, Mascia L, Ninniri C. et al. The increasing role of CT-guided cryoablation for the treatment of liver cancer: a single-center report. Cancers (Basel) 2022; 14 (12) 3018
- 19 Fairchild AH, Tatli S, Dunne RM, Shyn PB, Tuncali K, Silverman SG. Percutaneous cryoablation of hepatic tumors adjacent to the gallbladder: assessment of safety and effectiveness. J Vasc Interv Radiol 2014; 25 (09) 1449-1455
- 20 Zhang W, Gao X, Sun J. et al. Percutaneous argon-helium cryoablation for small hepatocellular carcinoma located adjacent to a major organ or viscus: a retrospective study of 92 patients at a single center. Med Sci Monit 2021; 27: e931473
- 21 Kim GM, Won JY, Kim MD. et al. Cryoablation of hepatocellular carcinoma with high-risk for percutaneous ablation: safety and efficacy. Cardiovasc Intervent Radiol 2016; 39 (10) 1447-1454
- 22 Yan Q, He F, Wang BQ. et al. Argon-helium cryoablation for liver carcinoma in high-risk locations: safety and efficacy. Cryobiology 2019; 90: 8-14
- 23 Zeng J, Qin Z, Zhou L. et al. Comparison between cryoablation and irreversible electroporation of rabbit livers at a location close to the gallbladder. Radiol Oncol 2017; 51 (01) 40-46
- 24 Kim R, Kang TW, Cha DI. et al. Percutaneous cryoablation for perivascular hepatocellular carcinoma: therapeutic efficacy and vascular complications. Eur Radiol 2019; 29 (02) 654-662
- 25 Cha SY, Kang TW, Min JH. et al. RF ablation versus cryoablation for small perivascular hepatocellular carcinoma: propensity score analyses of mid-term outcomes. Cardiovasc Intervent Radiol 2020; 43 (03) 434-444
- 26 Yang Y, Zhang Y, Wu Y. et al. Efficacy and safety of percutaneous argon-helium cryoablation for hepatocellular carcinoma abutting the diaphragm. J Vasc Interv Radiol 2020; 31 (03) 393-400.e1
- 27 Kwon JH, Won JY, Han K. et al. Safety and efficacy of percutaneous cryoablation for small hepatocellular carcinomas adjacent to the heart. J Vasc Interv Radiol 2019; 30 (08) 1223-1228
- 28 Li B, Liu C, Xu XX. et al. Clinical application of artificial ascites in assisting CT-guided Percutaneous cryoablation of hepatic tumors adjacent to the gastrointestinal tract. Sci Rep 2017; 7 (01) 16689
- 29 Wang C, Wang H, Yang W. et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma. Hepatology 2015; 61 (05) 1579-1590
- 30 Luo J, Dong Z, Xie H. et al. Efficacy and safety of percutaneous cryoablation for elderly patients with small hepatocellular carcinoma: a prospective multicenter study. Liver Int 2022; 42 (04) 918-929
- 31 Xu J, Noda C, Erickson A. et al. Radiofrequency ablation vs. cryoablation for localized hepatocellular carcinoma: a propensity-matched population study. Anticancer Res 2018; 38 (11) 6381-6386
- 32 Chen L, Ren Y, Sun T. et al. The efficacy of radiofrequency ablation versus cryoablation in the treatment of single hepatocellular carcinoma: a population-based study. Cancer Med 2021; 10 (11) 3715-3725
- 33 Dunne RM, Shyn PB, Sung JC. et al. Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: a comparison of the safety of cryoablation and radiofrequency ablation. Eur J Radiol 2014; 83 (04) 632-638
- 34 Hu J, Chen S, Wang X, Lin N, Yang J, Wu S. Image-guided percutaneous microwave ablation versus cryoablation for hepatocellular carcinoma in high-risk locations: intermediate-term results. Cancer Manag Res 2019; 11: 9801-9811
- 35 Shao Q, O'Flanagan S, Lam T. et al. Engineering T cell response to cancer antigens by choice of focal therapeutic conditions. Int J Hyperthermia 2019; 36 (01) 130-138
- 36 Erinjeri JP, Thomas CT, Samoilia A. et al. Image-guided thermal ablation of tumors increases the plasma level of interleukin-6 and interleukin-10. J Vasc Interv Radiol 2013; 24 (08) 1105-1112
- 37 Jansen MC, van Hillegersberg R, Schoots IG. et al. Cryoablation induces greater inflammatory and coagulative responses than radiofrequency ablation or laser induced thermotherapy in a rat liver model. Surgery 2010; 147 (05) 686-695
- 38 Ng KK, Lam CM, Poon RT. et al. Comparison of systemic responses of radiofrequency ablation, cryotherapy, and surgical resection in a porcine liver model. Ann Surg Oncol 2004; 11 (07) 650-657
- 39 Kawasaki T, Kawai T. Toll-like receptor signaling pathways. Front Immunol 2014; 5: 461
- 40 Redondo P, del Olmo J, López-Diaz de Cerio A. et al. Imiquimod enhances the systemic immunity attained by local cryosurgery destruction of melanoma lesions. J Invest Dermatol 2007; 127 (07) 1673-1680
- 41 Gaitanis G, Nomikos K, Vava E, Alexopoulos EC, Bassukas ID. Immunocryosurgery for basal cell carcinoma: results of a pilot, prospective, open-label study of cryosurgery during continued imiquimod application. J Eur Acad Dermatol Venereol 2009; 23 (12) 1427-1431
- 42 Lin M, Liang S, Wang X. et al. Cryoablation combined with allogenic natural killer cell immunotherapy improves the curative effect in patients with advanced hepatocellular cancer. Oncotarget 2017; 8 (47) 81967-81977
- 43 Young S, Hannallah J, Goldberg D. et al. Friend or foe? Locoregional therapies and immunotherapies in the current hepatocellular treatment landscape. Int J Mol Sci 2023; 24 (14) 11434
- 44 Brandi N, Renzulli M. The synergistic effect of interventional locoregional treatments and immunotherapy for the treatment of hepatocellular carcinoma. Int J Mol Sci 2023; 24 (10) 8598