Cryosurgery - Sarcoma

SUMMARY

Sarcomas can be treated by means of cryosurgery, which uses the introduction of thin needles under local anaesthetic with or without sedation (1). When these tumours are superficial, under the skin, they can be attacked using ultrasound scan guidance. When they on deep-seated organs like the liver, the kidneys or the lungs, CAT scan guidance is used  (2). For these cases too there is specific evidence from certain studies that demonstrate that cryosurgery specifically stimulates the immune system response to these tumours (3).

GENERAL INFORMATION

Sarcomas are tumours of connective tissue, and thus they can originate in subcutaneous fatty tissue, in smooth muscle tissue (found close to the viscera such as the intestine, the urethra, the renal pelvis and the bold vessels) or from striated muscular tissue, that is, what we commonly call muscles.  Connective tissue serves as a supporting structure for the organs, and is thus ubiquitous in the body: accordingly sarcomas can occur throughout the whole body. 

When a tumour is not malignant, that is, it tends to invade surrounding tissues as it grows, we speak of benign fibromas that have the same origin as them, but are less aggressive and usually are not fatal.  All these tumours, both benign and malignant, can be treated with cryosurgery, but introducing thin needles under local anaesthetic with or without sedation (1). When these sarcomas or fibromas are located under the skin, we can attack them using ultrasound scan guidance, and when they are in deep-seated organs like the liver, kidneys or lungs, CAT guidance is used (2). For these cases too, there is specific evidence from certain studies that demonstrate that cryosurgery specifically stimulates the immune system response to these tumours (3).

  1. Standardization of selection criteria for percutaneous image-guided cryoablation of recurrent soft-tissue sarcomas.
    Diagn Interv Imaging. 2014 Nov;95(11):1071-7. doi: 10.1016/j.diii.2014.02.008. Epub 2014 Mar 14.
    Lippa N1, Sargos P2, Italiano A3, Kind M1, Dallaudière B4, Hauger O4, Cornelis F5.
  2. Radiologically guided percutaneous cryotherapy for soft tissue tumours: A promising treatment.
    Diagn Interv Imaging. 2013 Apr;94(4):364-70. doi: 10.1016/j.diii.2013.02.001. Epub 2013 Mar 11.
    Cornelis F1, Havez M, Lippa N, Al-Ammari S, Verdier D, Carteret T, Amoretti N, Gangi A, Palussiere J, Hauger O, Grenier N.
  3. Cryoimmunology for malignant bone and soft-tissue tumors.
    Int J Clin Oncol. 2011 Apr;16(2):109-17. doi: 10.1007/s10147-011-0218-2. Epub 2011 Mar 12.
    Nishida H1, Yamamoto N, Tanzawa Y, Tsuchiya H.
  4. Initial Experience: Alleviation of Pain with Percutaneous CT-Guided Cryoablation for Recurrent Retroperitoneal Soft-Tissue Sarcoma.
    Fan WZ, Niu LZ, Wang Y, Yao XH, Zhang YQ, Tan GS, Yang JY, Li JP.
    J Vasc Interv Radiol. 2016 Dec;27(12):1798-1805. doi: 10.1016/j.jvir.2016.06.034. Epub 2016 Sep 9.