Evidence-based medical oncology and interventional radiology paradigms for liver-dominant colorectal cancer metastases

Table 4 Highlights of cryoablation literature for colorectal liver metastases

Ref.	Level of evidence	Year	Study details	1 yr OS%	3 yr OS%	5 yr OS%	Median OS (mo)	Procedure-related Complications
Rivoire et al[117]	II-2	2002	Retrospective, 24 patients, 69 lesions	92	58		39	21% (5/24) had iceball fracture, successfully treated with suture (all cryoablation performed at laparotomy)
			Laparotomy (Erbokryo CS-6)
			10-15 min freeze, 5 min thaw, 5-10 min freeze, occasionally with Pringle maneuver
			Mean 3 lesions
			Mean 4.5 cm max diameter
Yan et al[118]	II-2	2003	Prospective, 172 pts/420 lesions Laparotomy (L.C.S. 3000/Erbe) 1 cm margin, freeze-partial thaw-freeze Mean 4 lesions	89	41	19	28	28% (48/172) (all cryoablation performed at laparotomy, not percutaneously)
			Median 3.6 cm max diameter					Gelfoam packed into every tract
Brooks et al[119]	II-2	2005	Prospective, 93 patients	85	43	19	33	Cryoablation-related complications not specifically reported
			Laparotomy (L.C.S. 3000/Erbe)
			Median 2 lesions
Niu et al[120]	II-2	2007	Prospective, 124 pts/124 lesions	84	43	24	29	Not reported
			Laparotomy (L.C.S. 3000/Erbe)					Gelfoam was packed into every tract
			1 cm margin, freeze-partial thaw-freeze
			For lesions > 3 cm, two probes always used
			Mean 4 lesions
			Mean 4 cm max diameter
Paganini et al[121]	II-2	2007	Retrospective, 49 pts	87	43	23	31	22% (11/49)
			Laparotomy (CMS AccuProbe/Erbe)
			Mean 5 lesions
			Median 3 cm max diameter
Ng et al[122]	II-2	2012	Retrospective, 211 pts	87	21	12	27	Cryoablation-related complications not specifically reported
(Part 1)			Laparotomy (L.C.S. 3000/Erbe)
			Single-freeze thaw performed except for “smaller” lesions where partial double freeze-thaw performed
			Mean 4.4 lesions
	II-2	2012	Mean size 4 cm	87	31	17	34	Cryoablation-related complications not specifically reported
Ng et al[122]			Retrospective, 93 pts
(Part 2)			Laparotomy-assisted cryoablation of inadequate resection margins as determined by operator; (L.C.S. 3000/Erbe)
Shyn et al[123]	II-2	2014	Mean 2.2 lesions	Local progression at a mean interval of 30.3 mo (range 13-72 mo) was seen in 14/54 patients (26%). Survival not reported				Not reported
			Mean lesion size 5.7 cm
			Retrospective, 39 patients, 54 lesions
			Percutaneous (Galil)
			Median 4 probes (range 1-7) each 17 Gauge, 15 min freeze, 10 min passive thaw, 15 min freeze cycle
			Mean 1.4 lesions
			Mean lesion size 3 cm

Level of Evidence based on the United States Agency of Healthcare Research and Quality Classification of Levels of Evidence.