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 ± 20 months) was significantly longer than that of those who underwent chemotherapy (23 ± 24 months; p  = 0.0006). In the cryotherapy group, the OS for squamous cell carcinoma (45  ± 19 months) was longer than that for adenocarcinoma (33 ± 18 months; p  = 0.0435); the OS for timely cryoablation (46  ± 19 months) was longer than that for delayed cryoablation (33 ± 20 months; p  = 0.0193); the OS for multiple cryoablation (50 ± 17 months) was longer than that for single cryoablation (37 ± 20 months; p  = 0.0172); and the OS for cryoimmunotherapy (56 ± 17 months) was longer than that for cryoablation alone (39 ± 19 months; 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.