Mechanisms of cryoablation: Clinical consequences on malignant tumors
Open accessAbstract
While the destructive actions of a cryoablative freeze cycle are long recognized, more recent evidence has revealed a complex set of molecular responses that provides a path for optimization. The importance of optimization relates to the observation that the cryosurgical treatment of tumors yields success only equivalent to alternative therapies. This is also true of all existing therapies of cancer, which while applied with curative intent; provide only disease suppression for periods ranging from months to years. Recent research has led to an important new understanding of the nature of cancer, which has implications for primary therapies, including cryosurgical treatment. We now recognize that a cancer is a highly organized tissue dependent on other supporting cells for its establishment, growth and invasion. Further, cancer stem cells are now recognized as an origin of disease and prove resistant to many treatment modalities. Growth is dependent on endothelial cells essential to blood vessel formation, fibroblasts production of growth factors, and protective functions of cells of the immune system. This review discusses the biology of cancer, which has profound implications for the diverse therapies of the disease, including cryosurgery. We also describe the cryosurgical treatment of diverse cancers, citing results, types of adjunctive therapy intended to improve clinical outcomes, and comment briefly on other energy-based ablative therapies. With an expanded view of tumor complexity we identify those elements key to effective cryoablation and strategies designed to optimize cancer cell mortality with a consideration of the now recognized hallmarks of cancer.
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Clinical response to cryoablation is highly variable and lacks a reliable biomarker predicting a beneficial therapeutic outcome.
“Despite these theoretical advantages, clinical response to cryoablation is highly variable and suffers from the absence of a reliable biomarker that predicts a beneficial therapeutic outcome of this approach.15”
From Functional tumor cell-intrinsic STING, not host STING, drives local and systemic antitumor immunity and therapy efficacy following cryoablation (2023) · cites this paper as [15]
The Introduction describes inherent variability in cryoablative applications, and the Summary notes persistent disease after freezing. These passages partly support variable outcomes, but they do not establish that clinical response is highly variable or state that a reliable predictive biomarker is absent. Page numbers are unavailable in our copy. (LLM, conf=0.83)
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Self-citation
- Authors
- Baust, J. G., Gage, A. A., Bjerklund Johansen, T. E., & Baust, J. M.
- Affiliations
- Binghamton University (US)
- University at Buffalo, State University of New York (US)
- Corresponding author
- Baust, J.G.
- ORCID
- Baust, J.M.
- Venue
- Cryobiology
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 68
- Issue
- 1
- Pages
- 1-11
- ISSN
- 0011-2240 (ISSN-L)
- PMC
- PMC3976170
- OpenAlex
- W1985256611
- Cited by
- 239
- References
- 152
- Citations by year
- 2026: 29 · 2025: 20 · 2024: 22 · 2023: 22 · 2022: 23 · 2021: 26 · 2020: 17 · 2019: 17 · 2018: 14 · 2017: 17 · 2016: 12 · 2015: 11 · 2014: 4 · 2013: 2 · 2012: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cryobiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Ultrasound and Hyperthermia Applications
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
- Keywords
- cryoablation, cryosurgery, tumor biology, tumor microenvironment, cancer stem cells, tumor angiogenesis, antitumor immunity, adjunctive therapy, cancer hallmarks
- MeSH terms
- Combined Modality Therapy, Cryosurgery, Humans, Male, Neovascularization, Pathologic, Prostate, Prostatic Neoplasms, Neoplastic Stem Cells, Apoptosis, Tumor Microenvironment
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