Current evidence on the safety of cryotherapy for the treatment of liver metastases appears adequate in the context of treating patients whose condition has such a poor prognosis, but the evidence on efficacy is inadequate in quality. Therefore, cryotherapy for the treatment of liver metastases should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake cryotherapy for the treatment of liver metastases should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients and their carers understand that other ablative treatments are available and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having cryotherapy for liver metastases (see section 3.1).
Patient selection and treatment should be carried out by a hepatobiliary multidisciplinary team with expertise in the use of ablative techniques.