Hepatic cryosurgery for metastatic colorectal carcinoma.

PURPOSE/OBJECTIVES To review an innovative, potentially curative surgical approach for the treatment of select patients with colorectal cancer metastatic to the liver. DATA SOURCES Published articles and reported and unreported research results. DATA SYNTHESIS The liver is the primary site of recurrence in 60%-80% of patients who develop recurrent disease following resection of the colorectal primary cancer. Less than 25% of patients with liver metastases are candidates for hepatic resection because of the location or number of liver metastases. Hepatic cryosurgery provides a viable treatment option for some patients with unresectable metastatic colorectal carcinoma confined to the liver, including patients with bilobar and multiple lesions. CONCLUSIONS Because colorectal cancer is the second most common cause of cancer mortality in the United States, interventions that improve survival rates are an important focus of care. With knowledge of patient selection criteria and implications of hepatic cryosurgery, informed oncology nurses are resources for patients contemplating this therapy. IMPLICATIONS FOR NURSING PRACTICE Preoperative evaluation and postoperative nursing care focus on careful assessment, education, and interventions aimed at preventing and detecting complications unique to hepatic cryosurgery. Knowledge of hepatic cryosurgery as a treatment option for colorectal liver metastases, patient selection criteria, and related implications allows oncology nurses to serve as resources for patients and families considering this therapy.