OBJECTIVETo evaluate the safety and efficacy of intraoperative argon/helium cryosurgery in surgical resection of advanced hepatic carcinoma.

METHODSEighty-six surgical patients with advanced hepatic carcinoma were enrolled in this study, including 14 undergoing argon cryosurgery for tumor removal and 72 receiving cryosurgery in addition to surgical tumor reduction. Portal vein or hepatic arterial pump placement was performed in 15 patients for chemotherapy.

RESULTSNo death occurred in the operation or during the postoperative hospitalization period in these patients. Improvement of the clinical symptoms was observed in 66 cases (76.74%) and 43 (78.18%) patients showed significantly decreased blood AFP levels after the surgeries. Postoperative CT demonstrated obviously reduced tumor size in 58 cases (67.44%). Of the 70 patients available for the follow-up, 28 survived with a survival rate of 40%. The 0.5-, 1-, 3 and 5-year survival rates were 44/48 (91.67%), 35/48 (72.92%), 28/48 (58.33%), and 20/48(41.67%) in the patients with primary hepatic carcinoma (PHC), respectively, as compared with those of 21/22 (95.45%), 18/22 (81.82%), 13/22 (50.09%), and 8/22 (36.36%) in patients with metastasis hepatic carcinoma (MHC). The 1-, 3- and 5-year survival rates of the patients undergoing surgical tumor resection and cryosurgery were 65/72 (90.27%), 47/60 (78.33%) and 24/58 (41.38%), respectively, significantly higher than the rates of 10/14 (71.43%), 8/12 (66.67%) and 4/12 (33.33%) in the patients receiving cryosurgery only (P<0.05).

CONCLUSIONSArgon cryosurgery offers an effective and safe option for management of advanced hepatic carcinoma, and its combination with other therapeutic approaches may achieve better clinical effects.

Adult ; Aged ; Argon ; Carcinoma, Hepatocellular ; surgery ; Combined Modality Therapy ; Cryosurgery ; Female ; Helium ; Humans ; Liver Neoplasms ; secondary ; surgery ; Male ; Middle Aged ; Survival Analysis