ABSTRACT
Introduction: Cryosurgery for tumoural ablation traditionally involves instilling liquid nitrogen into a tumoural bed. The inability to control precise delivery can result in potentially disastrous consequences of skin necrosis and nitrogen gas embolism. In this study, we evaluated a probe-based closed cryosurgical system, which eliminates these risks.
Materials and Methods: We performed a prospective evaluation of 36 cases of bone tumours treated with a probe-based cryosurgical system at the National University Hospital, Singapore. Cases consisted of patients with benign aggressive tumours (42%), primary malignant bone tumours (25%) and bone metastases (33%). In primary bone tumours, the aim of therapy was cure. In bone metastasis, the aim of therapy was palliation defined as the relief of symptoms for the patients’ remaining lifetime. Results: We performed a prospective evaluation of 36 cases of bone tumours treated with a probe-based cryosurgical system at the National University Hospital, Singapore. Cases consisted of patients with benign aggressive tumours (42%), primary malignant bone tumours (25%) and bone metastases (33%). In primary bone tumours, the aim of therapy was cure. In bone metastasis, the aim of therapy was palliation defined as the relief of symptoms for the patients’ remaining lifetime. Conclusion: Good clinical efficacy with probe delivered cryotherapy has been shown in this group of 32 patients with cure in all primary disease. Relapse occurred in only a small proportion of patients with bone metastasis.Cold therapy has been used for thousands of years by the ancient Egyptians and later Hippocrates. The beginning of cryosurgery in modern medicine was originally proposed by an English physician, James Arnott between 1819 and 1879 who described the use of extreme cold to cause tissue destruction. Arnott combined a mixture of salt and crushed ice (“two parts finely pounded ice and one part of chloride of sodium”), which he applied to tumours. The desired clinical effects of controlling pain and haemorrhage were achieved. He stated that “a very low temperature will arrest every inflammation which is near enough to the surface to be accessible to its influence”. He treated breast and uterine cancer as well as some skin cancers. Although palliation was his initial aim, he recognised the potential of cold for curing cancer, stating that the cases he had seen “are therefore, by no means unfavourable to the supposition of the curability of cancer by congelation”
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
