Cryoprotective therapy for huge hepatocellular carcinoma: A study of 14 patients with a single lesion |
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| Institution: | 1. Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 of JieFang Road, Wuhan 430032, China;2. Fuda Cancer Hospital, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510665, China;3. Fuda Institute of Cryosurgery for Cancer, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510665, China;1. Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan;2. Diagnostic Pathology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan;3. CeloNova BioSciences, Inc., San Antonio, Texas;1. Department of Surgery, University of Louisville, Louisville, KY, USA;2. Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA;3. Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA;4. Department of Surgery, Ohio State University, Columbus, OH, USA;5. Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA;1. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg;2. Institute of Veterinary Pathology, Justus Liebig University Giessen, Giessen;3. Prolytic, Frankfurt am Main, Germany;1. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;2. Department of General and Transplant Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;3. Department of Gastroenterology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;4. Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;5. Liver Cancer Center Heidelberg, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;6. Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany;7. Department of Diagnostic and Interventional Radiology, Katharinenhospital Stuttgart, Stuttgart, Germany |
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| Abstract: | Percutaneous cryoablation is a potential cure for hepatocellular carcinoma (HCC). This study reviewed retrospectively clinical data from 14 patients who underwent cryoablation of huge HCC (long diameter >7 cm). The side effects of cryosurgeries and liver function reverse were recorded and compared everyday. All the patients survived cryosurgery and none died before leaving hospital 2 weeks later. Despite liver-protective treatment before cryosurgery, alanine transaminase (ALT) and aspartate transaminase (AST) levels were increased significantly, but returned to preoperative levels 2 weeks post-cryosurgery. Before cryosurgery, mean total bilirubin (T.BIL) and direct bilirubin (D.BIL) levels were normal; 8–10 days after cryosurgery, they increased more than two-fold, but returned to the preoperative level 2 weeks post-cryosurgery. Serum transaminase and bilirubin levels were compared between hepatitis B positive and negative patients. The hepatitis B negative group’s AST level increased significantly 1 day post-cryosurgery (mean, 186 U/L) and decreased to the preoperative level at day 14. In the hepatitis B positive group, means transaminase and bilirubin reached peak values at different days post-cryosurgery. Overall, ALT and AST are valuable indicators of liver function impairment following cryosurgery. In patients with hepatitis B virus, close attention to the serum bilirubin level should be paid 8–10 days after cryosurgery. Liver-protective treatment may alleviate liver function impairment caused by cryosurgery of huge HCC. |
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| Keywords: | Hepatocellular carcinoma Hepatic functional reserve Percutaneous cryoablation Liver-protective agent Transaminase Bilirubin |
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