Cryoablation: physical and molecular basis with putative immunological consequences
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that impacts all cellular processes. CA is independent of cell cycle stage and degree of cellular stemness. Importantly, CA is typically applied as a non-repetitive (single session) treatment that does not support adaptative mutagenesis as do many repetitive therapies. CA is characterized by the launch of multiple forms of cell death including (a) ice-related physical damage, (b) initiation of cellular stress responses (kill switch activation) and launch of necrosis and apoptosis, (c) vascular stasis, and (d) likely activation of ablative immune responses. CA is not without limitation related to the thermal gradient formed between cryoprobe surface (∼-185°C) and the distal surface of the freeze zone (∼0°C) requiring freeze margin extension beyond the tumor boundary (up to ∼1 cm). This limitation is mitigated in part by commonly applied dual freeze thaw cycles and the use of freeze sensitizing adjuvants. This review will (1) identify the cascade of damaging effects of the freeze-thaw process, its physical and molecular-based relationships, (2) a likely immunological involvement (abscopic effect), and (3) explore the use of freeze-sensitizing adjuvants necessary to limit freezing beyond the tumor margin.
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Clinical outcomes of tumor cryoablation-both obtaining local control and achieving an abscopal effect-are highly unpredictable with variable magnitudes of response and frequent failure of local recurrence.
“Despite these theoretical benefits, clinical outcomes of tumor cryoablation—both obtaining local control and achieving an abscopal effects—are highly unpredictable with variable magnitudes of response and frequent failure of local recurrence.”
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 [78]
The Cryo-immunological Responses section (page unavailable) says distant-tumor effects are not always observed, are transient, and vary in extent; the Introduction says freezing does not damage a targeted tumor uniformly. These passages support variable responses, but they do not establish that clinical local control is highly unpredictable or that local recurrence frequently occurs. (LLM, conf=0.84)
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Research progress on new physical therapies for cancer (Review)
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Cryoablation with KCl Solution Enhances Necrosis and Apoptosis of HepG2 Liver Cancer Cells
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Cryoablation of Prostate- Improving Efficacy and Safety
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Can Epicardial Ablation Create Optimal Cryolesions?
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Percutaneous Image-Guided Cryoablation of Metastatic Colorectal Adenocarcinoma to the Abdominal Wall
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- Authors
- Baust, J. G., Snyder, K. K., Santucci, K. L., Robilotto, A. T., Van Buskirk, R. G., & Baust, J. M.
- Affiliations
- Binghamton University (US)
- Cell Preservation Services (United States) (US)
- State University of New York, Binghamton, NY, USA;
- Corresponding author
- Baust, John G.
- Venue
- International Journal of Hyperthermia
- Publisher
- Informa UK Limited
- Published
- 2019-11-29
- Volume
- 36
- Issue
- sup1
- Pages
- 10-16
- ISSN
- 0265-6736 (ISSN-L)
- 1464-5157
- PMC
- PMC6897311
- OpenAlex
- W2992532374
- Cited by
- 76
- References
- 52
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 10 · 2023: 16 · 2022: 8 · 2021: 7 · 2020: 6
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Hyperthermia (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (1r43ca210761-01a1)
- National Cancer Institute (R44CA183265, R43CA183265, R43 CA210761)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Ultrasound and Hyperthermia Applications
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biotechnology › Microbial Inactivation Methods
- Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
- Keywords
- cryoablation, frost damage, ice formation, cellular stress response, necrosis, apoptosis, vascular stasis, abscopal effect, temperature gradient, tumor margin, cancer immunotherapy
- MeSH terms
- Cryosurgery, Humans
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