Cozzi P J, Englund R, Morris D L
University Department of Surgery, University of New South Wales, St. George Hospital, Sydney, Australia.
Cancer. 1995 Aug 1;76(3):501-9. doi: 10.1002/1097-0142(19950801)76:3<501::aid-cncr2820760322>3.0.co;2-x.
Liver metastases from neuroendocrine tumors often present with disabling symptoms due to syndromes of hormonal excess. A locally destructive technique such as hepatic cryotherapy not only alleviates symptoms but may improve survival in this group of patients.
Six patients with metastatic neuroendocrine tumors were treated with hepatic cryotherapy. Four patients were symptomatic and three of these had elevated tumor markers from ectopic hormone production.
All patients are alive and asymptomatic, with a median follow-up of 24 months (range, 6 months to 6 years). All have had a complete radiologic response. All with elevated preoperative markers have had a greater than 89% decrease in tumor markers. Coagulopathy occurred in two patients necessitating additional surgery, but there was no other morbidity attributable to the cryotherapy.
To the authors' knowledge, this study demonstrates for the first time that hepatic cryotherapy offers supportive treatment for patients with neuroendocrine tumors metastatic to the liver. Cryotherapy alleviates symptoms and may improve survival.
神经内分泌肿瘤的肝转移常因激素过多综合征而出现致残症状。诸如肝脏冷冻疗法这样的局部破坏性技术不仅能缓解症状，还可能改善这类患者的生存率。
6例转移性神经内分泌肿瘤患者接受了肝脏冷冻疗法。4例患者有症状，其中3例因异位激素产生导致肿瘤标志物升高。
所有患者均存活且无症状，中位随访时间为24个月（范围6个月至6年）。所有患者均有完全的影像学缓解。所有术前标志物升高的患者肿瘤标志物下降幅度均超过89%。2例患者出现凝血障碍，需要再次手术，但没有其他可归因于冷冻疗法的并发症。
据作者所知，本研究首次表明肝脏冷冻疗法为肝转移神经内分泌肿瘤患者提供了支持性治疗。冷冻疗法可缓解症状并可能改善生存率。
