Ovarian cancer, which killed 15,000 American women last year, is one of the deadliest forms of cancer. A team of Wayne State University School of Medicine researchers recently proved that freezing tumors increases survival rates in ovarian cancer patients.
The “freeze and destroy” technique is an alternative for local treatment of cancerous tumors, said Peter Littrup, M.D., professor of radiology in the School of Medicine and director of imaging core and radiological research at the Barbara Ann Karmanos Cancer Institute.
Ovarian cancer is the most damaging cancer to attack the female reproductive system, with close to 22,000 women diagnosed each year, according to the National Institutes of Health. While surgery and chemotherapy have proved effective in treating cancer as a systemic disease, cryoablation is an option when the disease is in the late stages and is oligometastatic, meaning the tumors are limited in number and location.
Hyun Bang, M.D., a resident in WSU’s Department of Radiology, presented the findings at the International Symposium on Endovascular Therapy in Miami, Fla., last month. In 98 percent of the 21 patients surveyed in the study, a survival rate of 56 months, or approximately 4.6 years, was reported. The majority of women whose tumors aren’t successfully removed surgically – some 60 percent according to studies – survive only seven months to 2.5 years in comparison.
The study also concluded that medical costs were on average $26,806 per life year saved, nearly 75 percent less than the current standard of $100,000. (Average cost is $15,000 per treatment.) Littrup credited Bang with recognizing the evidence of effective data and taking the initiative to prove his technique worked.
“We hit a home run,” Bang said.
The WSU team treated 48 tumors on the soft tissue, liver and lungs of 21 women over seven years in an outpatient setting. The treatment is performed using an extremely cold needle inserted into the skin, using imaging technology such as ultrasound for guidance. The treatment, called cryoablation, causes less pain and faster recovery than surgery.
Killing tumors by freezing them can add precious time to the lives of women with ovarian cancer that has spread to other parts of the body. Minimally invasive cryoablation extends lives and is cost-effective, according to a study being presented at the 4th annual Symposium on Clinical Interventional Oncology (CIO), in collaboration with the International Symposium on Endovascular Therapy (ISET).
Once the cancer has spread (metastasized) beyond the ovaries, it is usually incurable, but surgery is often used to remove the tumors and extend life. Depending on the location of the tumors, however, that may not be an option, especially if the patient has previously undergone surgery to remove the cancer. The study shows cryoablation may be used to kill these tumors with extreme cold, resulting in significant survival time.
The study included 21 patients whose tumors in the abdomen, liver, lung and bone could not be removed surgically. Cryoablation was used to treat 48 tumors, killing 47 of them (98 percent). From the time of diagnosis of metastatic disease, average patient survival time was more than four years and seven months. That’s significant because women whose tumors are not successfully removed surgically – which occurs in about 60 percent of cases, according to studies – typically survive from about seven months to 2 years. On average, more than three years had transpired from the time of diagnosis to the first cryoablation treatment, meaning these women had already passed their expected survival time, and yet cryoablation was able to extend their survival even further. Some patients had multiple cryoablation treatments and of 41 procedures, there were three major complications (7 percent). The complications included two deaths that were attributed to the cancer, not to the procedure.
The study also determined the treatment extremely cost-effective, costing an average of $26,806 per life year saved, well below the current standard of $100,000.
In the study, “Cryoablation of Metastatic Ovarian Cancer for Local Tumor Control: Improved Survival and Estimated Cost-Effectiveness,” Littrup and Bang, along with a team of researchers, demonstrate that targeted therapy for tumors in ovarian cancer patients increases survival and lessens recurrence rates in patients in the very late stages of the disease.
Armed with at least seven years of data, Bang recognized the long-term effectiveness of the treatment and the financial benefits, leaning on his pre-doctoral experience in economics and finance. If you have enough evidence and proven data, “eventually, people will start listening,” Bang said.
The team has published two papers related to the findings as they relate to kidney and lung cancers, with a third recently submitted on colon cancer.
Littrup has cryoablated approximately 1,000 tumors to date in various soft tissues and organs, starting with the prostate in 1992.
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