HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maiwand, M.O. Search for Related Content PubMed PubMed Citation Articles by Maiwand, M.O.

Eur J Cardiothorac Surg 1999;15:764-768
© 1999 Elsevier Science NL

The role of cryosurgery in palliation of tracheo-bronchial carcinoma

Harefield Hospital, Harefield, Middlesex UB9 6JH, UK

Received 21 September 1998; received in revised form 26 February 1999; accepted 17 March 1999.

Tel./fax: +44-1895-828558
e-mail: cryoresearch{at}rbh.nthames.nhs.uk

Objective: Carcinoma of the lung is the commonest cause of death from malignant disease in humans. At diagnosis, about 85% of patients are in an advanced stage of the disease and approximately 30% present with a tumour blocking a large bronchial lumen, causing distressing and life threatening symptoms. Early reopening and treatment of the blocked airways is required to improve symptoms and quality of life. There are a number of methods available to achieve this aim including cryotherapy, the controlled application of extreme cold. Methods: We present a prospective study of 153 consecutive patients, cryotreated between January 1995 and December 1997 with a mean age of 68.8 years and a male:female ratio of 1.59:1. The procedure can be performed under general or local anaesthetic using a rigid or flexible cryoprobe. A temperature of about -70°C is delivered to the tumour site for two 3-min periods causing destruction of the tumour mass. Patients were evaluated clinically and for performance status before and after treatment. Histological composition was: non-small cell 88.2%, small cell 11.1% and malignant melanoma 0.7%. The TNM staging for NSC patients, at the time of treatment was stage II 8.2%, IIIa 27.4%, IIIb 25.9%, IV 38.5%. Results: Subjective symptomatic improvement for cough was 68.3%, dyspnoea 63.9%, haemoptysis 92.7% and chest pain 55.5%. Respiratory function tests showed improvements in mean FEV1 from 1.34l to 1.45l (P=0.001) and mean FVC from 1.93 to 2.02 l (P=0.035). The Karnofsky performance status increased by 54.6%. Kaplan–Meier median survival time was 12.9 months. Complications were found with 11 patients (7.2%) and there was no operative mortality. Conclusions: Cryotherapy provides effective and rapid control of symptoms caused by tracheobronchial carcinoma and improves quality of life and survival. It is easy to perform, with minimum complications and the majority of patients are discharged the same day.

Key Words: Cryotherapy • Tracheobronchial • Palliation • Lung cancer

This article has been cited by other articles:

				M. Kawamura, Y. Izumi, N. Tsukada, K. Asakura, H. Sugiura, H. Yashiro, K. Nakano, S. Nakatsuka, S. Kuribayashi, and K. Kobayashi Percutaneous cryoablation of small pulmonary malignant tumors under computed tomographic guidance with local anesthesia for nonsurgical candidates J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1007 - 1013. [Abstract] [Full Text] [PDF]

				S M Cooper and R P R Dawber The history of cryosurgery J R Soc Med, April 1, 2001; 94(4): 196 - 201. [Full Text] [PDF]