P0078 Percutaneous comprehensive cryoablation for metastatic oesophageal cancer after failure of radical surgery.

Background: Oesophageal cancer is common in China. There is a lack of treatment strategies for metastatic oesophageal cancer (MEC) after radical surgery on the primary tumour. Cryoablation is an attractive option because tumour necrosis can be safely induced in a minimally invasive manner. This study assessed its therapeutic effect in MEC after failure of radical surgery. Methods: One hundred and forty patients met the inclusion criteria between May 2003 and March 2011. Comprehensive cryotherapy of multiple metastases was performed on 105 patients; 35 received chemotherapy. Overall survival (OS) was assessed according to therapeutic protocol, pathological type, treatment timing, and number of procedures. Findings: No severe complications occurred during or after cryoablation. The OS of patients who received comprehensive cryoablation (44±20months) was significantly longer than that of those who underwent chemotherapy (23±24months; p=0.0006). In the cryotherapy group, the OS for squamous cell carcinoma (45 ±19months) was longer than that for adenocarcinoma (33±18months; p=0.0435); the OS for timely cryoablation (46 ±19months) was longer than that for delayed cryoablation (33±20months; p=0.0193); the OS for multiple cryoablation (50±17months) was longer than that for single cryoablation (37±20months; =0.0172); and the OS for cryoimmunotherapy (56±17months) was longer than that for cryoablation alone (39±19months; p=0.0011). Interpretation: Comprehensive cryotherapy could have advantages over chemotherapy in the treatment of MEC and, in patients with squamous cell carcinoma, supplementary immunotherapy and timely and multiple cryoablation could be associated with a better prognosis. [ABSTRACT FROM AUTHOR]