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At least 19 recordsLinked to original sources
PubMed1989

[Sequential MRI and CT monitoring in cryosurgery--an experimental study in rats].

Cryosurgery is one of treatments of cancer, such as carcinomas of the face, oral cavity, prostate, breast, rectum and liver. But the method of cryosurgery seemed to be not yet completely established. The most important problem in this procedure is to define the extent of the cryolesion. But the trial with MRI and CT has not been reported. The purpose of this study is to investigate whether the image diagnosis such as Magnetic Resonance (MR) and CT is useful for the determination of the region during and after cryosurgery. The animal experiments were performed using 13 Wistar rats with inoculated Walker 256 cancer on both sides of femoral regions subcutaneously in the concentration of 1 million cells. After 7 days, cryosurgery was done by contacting for 15 sec with the absorbent cotton ball dipped in liquid nitrogen to the surface of right femoral tumor 3 to 6 times. The left side of tumor was intact. MRI was performed with a 0.1 Tesla ASAHI MR Mark-J and CT images were obtained using GE 9800. From the freezing to thawing, LF image (Low Flip Angle gradient echo image of Tr = 100 msec, Te = 18 msec, 60 degrees of flip angle) of MR and plain CT were taken every one minute. After thawing is over, SE image of Tr = 1500 msec, Te = 90 msec, IR images of Tr = 1200 msec, Td = 400 msec, and plain and contrast enhanced CT were carried out. Two and 7 days after cryosurgery, LF, SE and IR images of MR and CT with and without contrast medium were obtained with corresponding pathological examinations. The frozen cryolesion was of no signal intensity on the LF MR image and hypodensity on plain CT. Identification of cryolesion became possible during the cryosurgery. The cryolesion immediately after thawing showed higher intensity on the SE and LF images and hypodensity on enhanced CT. Therefore, the extent of cryosurgery can be diagnosed easily by these methods during and immediately after cryosurgery. In the follow-up studies after cryosurgery, the histological changes such as necrosis or tissue reaction were well represented by MRI and enhanced CT, but insufficiently by plain CT. From these experimental results, it may be concluded that MRI and CT are useful for monitoring the process of cryosurgery during and after the procedure.

Animals↗
PubMed1975

Combined chemotherapy and cryosurgery for oral cancer.

The inadequacies of traditional methods for control of advanced oral carcinomas at their sites of origin prompted evaluation of combined chemotherapy and cryosurgery in seventy-three patients treated since 1969. Our experience with thirty-nine unlikely candidates for salvage by other therapy is the subject of this report. The majority had recurrent disease after other therapy. The observed morbidity potential of combined chemotherapy and cryosurgery with earlier experience led to abbreviations and refinements of method that are described and consist mainly of the following. (1) A two day postcryosurgical infusion (intra-arterial) of 5-fluorouracil (1 gm per twenty-four hours, or less) in lieu of methotrexate, the systemic toxicity and therapeutic efficacy of which seem less predictable with cryosurgery. (2) Electrosurgical subtotal tumor resection at the time of initial cryosurgery to reduce swelling and magnitude of in situ tissue slough. (3) Use of a flexible copper mesh cryoprobe that enhances feasibility of in-depth wide field cryosurgery. (4) Systematic use of multiple marginal wound biopsies as a principal guide to repetitive cryosurgery or other therapeutic adjunct selection. A special warning that available toxicologic data for independent drug therapy may not be applicable in patients after cryosurgery is given. Current experience indicates that negative biopsy after such combined therapy may be 85 per cent reliable in foretelling lesion outcome. Among the thirty-nine patients reported, twenty remain alive from six months to six years, only two of whom have clinically evident recurrent disease. If such could be reasonably accomplished, comparative evaluation of single methods should precede attempts to combine two or more modes of therapy. Since neither chemotherapy nor cryosurgery, as known today, can eliminate nodal metastases, each must be regarded as potentially adjunctive to other methods for achieving the ultimate goal of a cancer-free patient. It is within this context that combined chemotherapy and cryosurgery have been applied to unfavorable candidates for cure with seemingly worthwhile gains. Potential applicability for patients with less formidable stages of disease cannot be extrapolated from this experience. Large scale controlled clinical trials must provide the ultimately conclusive test of efficacy for such combined forms of therapy before decisive revision of traditional standards of practice might result.

Adult↗
PubMedDate not supplied

Cryosurgery for ocular and periocular lesions.

This preliminary report suggests that cryosurgery has a definite place in the management of certain external periocular and ocular problems. Cryosurgery for basal- or squamous-cell carcinoma of the lid is easily performed, gives excellent cosmetic results, and has a low recurrence rate. It is not recommended for lesions involving the fornices, nor for sclerotic or morphea-type basal-cell carcinomas. Tumor recurrences following radiation, surgery, or cryosurgery can still be retreated with cryosurgery. To date, there is no evidence that cryosurgery at temperatures above --40 degrees C causes damage to the lacrimal outflow system. Cryosurgery is of value in the management of trichiasis, reactive lymphoid hyperplasia, spider hemangioma, molluscum contagiosum, and conjunctival dysplasia. Cryotherapy for management of intraepithelial epithelioma and squamous-cell carcinoma of the conjunctiva and cornea is still under investigation. Cryosurgery will, in our opinion, become the treatment of choice for basal- and squamous-cell carcinomas of the eyelids. The 96% cure rate with one treatment for these lesions reported here is artificially high since the follow-up period is too short. However, retreatment with cryosurgery is a simple 10- min outpatient procedure which is certainly not the case with recurrences after other forms of therapy.

Animals↗
PubMed1992

Cryosurgery in the treatment of cancer.

The range of application of cryosurgical techniques to the treatment of cancer is widely diversified and slowly increasing in scope. From these, one may reach the general conclusion that cryosurgical techniques are a standard method of treatment, competitive with other methods of therapy, in cancer located in some sites. For cancers located in other sites, cryosurgery is only useful as an end resort in selected patients. In some areas, especially in the viscera, cryosurgical techniques are only in developmental stages. Cryosurgery is most useful in easily accessible areas of the body. The results of the treatment of most carcinomas of the skin with cryosurgical techniques are as good as any other method of therapy. In carcinoma involving skin, cryosurgery has a special advantage in those situations when malignant tissue overlies bone. Cryosurgery is also useful in the management of dysplastic disease or carcinoma in situ, principally in the oral cavity and the uterine cervix. These applications are sufficiently valuable to be included in the textbooks concerned with those areas. Invasive cancer in other accessible sites, such as the oral cavity or the rectum, can be cured by cryosurgery, but the reports in the medical literature have not led to general use of the technique or descriptions of the technique in textbooks, except for occasional brief mention. Nevertheless, patients who are at high risk for surgical treatment because of coagulopathy or severe cardiopulmonary disease are appropriate candidates for the use of cryosurgical techniques. In the oral cavity, the possibility of preserving the bony structure is an attractive feature that maintains interest in cryosurgery. Unfortunately, there are no control studies to assist in the judgment of merit and in many cited reports, it is not easy to determine the survival rate or compare results with conventional therapy. In these sites, freezing techniques are more often used to achieve palliation of distressing symptoms by tumor bulk reduction, especially when little else can be done, and under these conditions, chemotherapy and radiotherapy are also commonly used. In less accessible sites, which generally require endoscopic or surgical exposure, cryosurgery is not often used. The treatment of carcinoma of the prostate gland by cryosurgery remains viable because of continued interest in the potentiation of immunologic defenses against carcinoma. This possible benefit is most evident in experimental tumors, but clinical evidence of benefit is not as clear.(ABSTRACT TRUNCATED AT 400 WORDS)

Cryosurgery↗
PubMedDate not supplied

The role of cryosurgery in external ocular and periocular disease.

This preliminary report suggests that cryosurgery has a definite place in the management of certain external periocular and ocular problems. Cryosurgery for basal or squamous cell carcinoma of the lid is easily performed, gives excellent cosmetic results, and has a low recurrence rate. It is not recommended for lesions involving the fornices, or sclerotic and morphea-type basal cell carcinomas. Tumor recurrences following radiation, surgery, or cryosurgery can still be retreated with cryosurgery. To date, there is no evidence that cryosurgery at temperatures above -40 C causes damage to the lacrimal outflow system. Cryosurgery is of value in the management of trichiasis, reactive lymphoid hyperplasia, spider hemangioma, molluscum contagiosum, and conjunctival dysplasia. Cryotherapy for management of intraepithelial epithelioma and squamous cell carcinoma of the conjunctiva and cornea is still under investigation. Cryosurgery will, in our opinion, become the treatment of choice for basal and squamous cell carcinomas of the eyelids. The 96% cure rate with one treatment for these lesions reported here is artificially high since the follow-up period is too short. However, retreatment with cryosurgery is a simple ten-minute outpatient procedure which is certainly not the case with recurrences after other forms of therapy.

Basal Cell Carcinoma↗
PubMed1988

Characterisation of suppressor cells generated following cryosurgery of an HSV-2-induced fibrosarcoma.

Cryosurgery of a primary HSV-2-induced hamster fibrosarcoma resulted in the generation of a population of suppressor cells. These cells were detectable in the spleen 1-10 days post-cryosurgery by their ability to suppress the proliferation of immunocompetent splenic T-lymphocytes following exposure to concanavalin A (Con A). The spleens of tumour-bearing (t.b.) animals which received cryosurgery 3 days previously displayed gross splenomegaly due to the generation of large numbers of highly proliferative erythroblasts. The erythroblast cells were unlikely to be the source of suppression since time course studies have demonstrated the presence of suppressor cells before and after their appearance in the spleen. The erythroblasts therefore probably reflected a response by the host to regenerate the erythrocytes lost during surgery and their presence was independent of the appearance of suppressor cells. Characterisation of the suppressor cell has revealed it to be non-adherent and esterase negative making it unlikely to be of macrophage (MO) lineage. This was confirmed by the ability of splenic MOs from day 3 t.b. cryosurgery-treated animals to completely restore Con A-dependent T-lymphocyte proliferation following MO depletion. As nylonwool column-eluted cells are able to suppress Con A-dependent T-lymphocyte proliferation, it seemed unlikely that B-lymphocytes play a role in cryosurgery-induced immunosuppression. These findings suggest that cryosurgery of a t.b. animal results in the generation of a population of T-lymphocytes capable of suppressing Con A-dependent T-lymphocyte proliferation, and infers that these cells contribute to the inferior prognosis following cryosurgery as compared to excision of a metastatic tumour.

Animals↗
PubMed1988

Current progress in cryosurgery.

The 4-day sessions of the Eighth Annual Meeting of the American College of Cryosurgery in New Orleans, February 18-21, 1988, provided an intense overview of the position of cryosurgery in modern day medical practice. The variety of speakers demonstrated that interest in the therapeutic technique of cryosurgery remains high and that usage is greater, more diversified, and more selective than in past years. Emphasis at the meeting was placed on the selective use of cryosurgery, that is, defining the terms under which the physician would choose between diverse methods of local therapy, such as excision, electrosurgery, laser surgery, and cryosurgery. Most of the presentations were oriented clinically with emphasis on the results of cryosurgery. This brief report is intended to mention the important new developments in cryosurgery and to focus on some of the issues and needs that affect the future of the technique.

Cryosurgery↗
PubMed1988

Comparison of excision versus cryosurgery of an HSV-2-induced fibrosarcoma. I. Survival, extent of metastatic disease and host immunocompetence following surgery.

Cryosurgery and excision were used to treat primary tumours of HSV-2-transformed hamster tumour sublines, and post-operative survival and the extent of metastatic disease were compared in the two groups. An inferior prognosis was observed following cryosurgery although the extent of metastatic disease was similar in both groups. Using this model it would appear that cryosurgery enhances the development of micrometastases rather than affecting the number of cells shed from the primary tumour during surgery. To investigate the underlying causes of the decrease in survival following cryosurgery, in vitro assays were used to monitor host immunocompetence following surgery. The results showed that whilst natural killer cell cytotoxicity was only marginally depressed, mitogen responsiveness and lymphocyte participation in a mixed lymphocyte reaction were severely reduced 3-7 days post-cryosurgery. In parallel with immunosuppression, extensive cell proliferation in the spleen of cryosurgically treated tumour-bearing animals was observed. Histological examination of the spleen demonstrated the presence of large numbers of transformed cells which correlated with the loss of mitogen responsiveness and the ability to participate in a mixed lymphocyte reaction. Further studies (manuscript submitted for publication) have demonstrated that spleen cells from animals whose tumour is treated by cryosurgery are capable of suppressing immunocompetence in vitro, implying they have a role in the uncontrolled growth of micrometastases in vivo.

Animals↗
PubMed1989

Bone marrow embolism following cryosurgery of bone: an experimental study.

Cryosurgery is commonly used in medicine for treatment of benign and malignant lesions. We had clinical and experimental data indicating that cryosurgery of intact bone could cause bone marrow intravasation and embolism, i.e., particles of bone marrow entering extraosseous veins and occluding pulmonary vasculature. This study was designed to investigate the pathogenesis of bone marrow intravasation and embolism after cryosurgery. Three hypotheses on the pathogenesis of bone marrow intravasation were tested using a model of cryosurgical continuity lesion in rats and rabbits. Influence of physical and circulatory factors were excluded supporting a mechanical-biological hypothesis; the intravasation of bone marrow after cryosurgery of bone is caused by an increased intramedullary pressure. The increased intramedullary pressure is due to edema in the medullary cavity caused by cryosurgical damage to cell membranes. It is demonstrated that the bone marrow intravasates can embolize to the lungs causing respiratory insufficiency. This can be a serious complication following cryosurgery of intact bone. Prophylactic decompression of the medullary cavity can possibly prevent the rise in intramedullary pressure and thus intravasation and embolisation of bone marrow after cryosurgery of intact bone.

Animals↗
PubMed1977

Cryosurgery of bronchopulmonary structures. An approach to lesions inaccessible to the rigid bronchoscope.

Cryonecrosis of the upper lobe of the lung and bronchi was safely inudced in healthy dogs by application of the cryoprobe to serosal surfaces or, through a bronchotomy, to the mucosal surfaces under direct vision. Seven days after cryosurgery, hyperemia of the bronchus was seen. By 14 days the bronchus at the target site was covered with cuboidal epithelium. Reappearance of normal ciliated epithelium occurred by 180 days after cryosurgery. Cartilage remained intact, and there was no evidence of formation of a stricture or other gross alteration of bronchial architecture. In the lung there was coagulation necrosis; and by 14 days after cryosurgery, there was fibrosis in the target area. There were no complications of the pleural space. Cryosurgery of tissues at the margins of the bronchotomy does not impair healing. Cryosurgery may reduce the necessity for extensive surgery in selected patients with bronchopulmonary tumors, including those inaccessible to the rigid bronchoscope. Clinically, eight patients with recurrent bronchogenic tumors have received palliation by transbronchoscopic cryosurgery.

Animals↗
PubMed1988

The effect of cryosurgery and polymethylmethacrylate in dogs with experimental bone defects comparable to tumor defects.

The effects of liquid nitrogen (LN) and polymethylmethacrylate (PMMA) on normal bone, bone graft incorporation, and reossification were evaluated by simulating a tumor in dogs with experimental bone cavity. Ten skeletally mature mongrel dogs (20 femora) were divided into three groups: Group I, controls; Group II, LN (with and without bone graft); and Group III, PMMA (with and without LN). Roentgenograms, whole-mount histology, and tetracycline fluorescence studies were performed on the distal femur. Correlation of these studies showed that (1) marked trabecular and bone necrosis, extending 7-12 mm around the circumference of the cavity, developed by three and seven weeks after LN but no bony necrosis occurred after PMMA; (2) the pattern of reossification following cryosurgery was delayed and abnormal, demonstrating increased calcification and metaplastic bone formation; (3) cryosurgery decreased the rate of bone graft incorporation; (4) the cryonecrotic rim following cryosurgery correlated with an abortive attempt at peripheral reossification; and (5) cryosurgery had no effect on the articular cartilage. Cryosurgery is effective in causing bone necrosis, whereas PMMA is not, and the pattern of reossification is delayed and altered by freezing. This study suggests that microvascular thrombosis with subsequent ischemic infarction of bone is a major cause of bone necrosis following cryosurgery.

Animals↗
PubMed1991

Ultrasound-guided hepatic cryosurgery in the treatment of metastatic colon carcinoma. Preliminary results.

Cryosurgery, the in situ freezing of cancer, has been proposed in the past as a possible treatment for unresectable hepatic tumors. Its advantage lies in the fact that it is a very focal treatment sacrificing less normal tissue than surgical resection, allowing treatment of multiple lobes. Because cryosurgery does not affect large vessels, tumors in difficult locations, such as adjacent to the inferior vena cava (IVC), can be treated. With the use of intraoperative ultrasound to place the cryoprobes and monitor the freezing process, 18 patients with unresectable metastatic colon carcinoma confined to the liver were treated. Of the 18 patients treated, 4 (22%) are in complete remission as determined by computed tomography (CT) scans and carcinoembryonic antigen (CEA) levels, with a mean follow-up of 28.8 months. Four patients (22%) were not adequately treated at the time of cryosurgery. The number of lesions frozen in each patient ranged from 1 to 12, with a mean of 6 lesions. Fourteen patients had bilobar disease; three patients had previous right lobectomies with recurrences in their remaining left lobes prior to cryosurgery, and one patient had unilobar disease. Mean survival of the 14 cases with recurrence was 21.4 months, with 2 of the 14 still alive. Ultrasound-guided hepatic cryosurgery appears to be an effective treatment for metastatic colon carcinoma to the liver that is unresectable (including patients with bilobar and multiple lesions). These preliminary results indicate that the procedure warrants further study.

Adult↗
PubMed1992

Progress in cryosurgery.

The Workshop on Cryosurgery at the 28th Annual Meeting of the Society for Cryobiology contained a diversity of papers which fairly represented the present state of cryosurgery in medical practice and which identified directions for future research. Emphasis was clearly on the development of visceral cryosurgery, which appears likely to become of increased clinical importance as a result of combination with ultrasound imaging techniques. This report reviews in brief the important new developments in cryosurgery and focuses on those presentations which were of special interest from the viewpoint of research in cryosurgery.

Cryosurgery↗
PubMed1979

Six years' experience with cryosurgery in the oral cavity.

Ninety selected patients with a benign or malignant lesion in the oral cavity were treated by cryosurgery. A clinical study was carried out during a 6-year period to investigate the value of cryosurgery as supplemental or substitute therapy. Good results have been obtained in the treatment of small to moderate, superficially situated angiomas. Cryotherapy has also been found to be satisfactory in the treatment of papillary hyperplasia of the palate. As symptomatic treatment we employed the freezing procedure to painful erosive lichen planus. Until now, a casual treatment has not been possible because of an unknown etiology. Used as symtomatic therapy, cryosurgery may be of some use in these cases, especially to relieve pain. Good results have been obtained in the treatment of oral leukoplakia. The pathologically changed mucous membranes could be completely eliminated in most of the cases without severe scar formation or impairment to functions. Cryosurgery for palliation was employed in 11 incurable tumors. Results have been disappointing. Twenty-one localized malignant neoplasms were treated by cryosurgery to cure. The tumor was completely destroyed in 67% of the cases.

Adolescent↗
PubMed1991

Natural killer cell activity following cryosurgery of normal and tumour bearing liver in an animal model.

Cryosurgery is a useful tool to treat unresectable liver carcinoma. In addition to the local effects of freezing, cryosurgery is thought to affect host immune response. We tested this by measuring natural killer (NK) cell cytotoxicity following cryosurgery of normal liver and an implanted liver tumour in the rat. Controls underwent sham cryosurgery. NK cytotoxicity was enhanced following cryosurgery of normal liver and liver tumour.

Animals↗
PubMed1990

[Changes in immunoparameters following cryosurgery in prostate cancer].

To determine the effect on immunoparameters of cryosurgery in cases of stage B prostatic cancer and to determine whether such changes were specifically related to the cryosurgery technique, immunoparameters were measured and compared with cases of prostatic hyperplasia treated by transurethral resection (TUR-P). A decrease in immunoparameters was recognized in the cryosurgery group at 1-3 days postoperatively (increase in IAP, decrease in NK cell activity, decrease in lymphocyte blastogenesis reaction to PHA). The protein histograms, immunoglobulin and IAP changed similarly after the two above procedures. These changes were thought to be due to the invasive nature of the procedures. However, some difference was seen between the cryosurgery group and the TUR-P group in terms of rate of lymphocyte blastogenesis reaction to PHA and Con A, IgG, complement and NK cell activity which might indicate a specific effect of cryosurgery different from TUR-P.

Aged↗
PubMed1989

[Changes in tumor markers following cryosurgery of prostate carcinoma].

Cryosurgery is performed in poor risk cases of prostate carcinoma with dysuria. This modality has been reported to reduce the metastatic lesion postoperatively in cases of prostate carcinoma accompanied by metastasis and is employed as an adjuvant therapy of prostate carcinoma. However, many cases are already at an advanced stage and have undergone other therapeutic modalities and as a result the exact role of cryosurgery in prostate carcinoma is not clear. The present investigation was undertaken to clarify the effectiveness of cryosurgery in prostate carcinoma. The patients consisted of 21 untreated cases of histologically confirmed prostate carcinoma admitted our hospital during the 5-year period from December, 1982 to December, 1987, in all of whom treatment by cryosurgery alone was indicated, i.e., up stage B, and in whom changes in prostate carcinoma tumor markers, alkaline phosphatase (ALP), acid phosphatase (ACP), prostatic ACP detected enzymatically (PACP), and by radioimmunoassay (PAP), gamma-seminoprotein (gamma-Sm), and prostate specific antigen (PSA) were measured. During the same period, changes in tumor makers in 11 cases of prostate hypertrophy treated by transurethral resection of prostate (TUR-P) were also examined. The tumor markers were measured prior to cryosurgery and 1, 3, 7 and 14 days postoperatively as well as at 1, 3 and 6 months. Following TUR-P, in the cases of prostate hypertrophy, no postoperative changes in ALP, ACP or PACP were observed but there was elevation of PAP and gamma-Sm at day 1 and elevation of PSA until day 3, but none of these were statistically significant differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Phosphatase↗
PubMed1989

Cryosurgery versus dilation and massage for the treatment of recurrent urethral syndrome.

One year after the initiation of a prospective, randomized, crossover trial comparing dilation and massage to urethral cryosurgery utilizing a specially designed urethral cryoprobe, our results show that cryosurgery was more effective in the treatment of recurrent urethral syndrome in women. Ninety-one percent of patients first treated with cryosurgery were successful in achieving relief from their symptoms whereas only 33% of the women initially treated with dilation and massage were successful (P = .005). In addition, cryosurgery was more successful in treating women when they crossed over after failing the other therapy (75% vs. 0%). In total, 21 of 24 patients (87.6%) were treated successfully with one of the two modalities. Nineteen of the 22 patients (86.4%) in this select group treated with cryosurgery during the trial were successful, whereas only 5 of 15 (33.3%) treated with dilation and massage were successful (P = .001).

Cryosurgery↗