{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T21:46:15Z","timestamp":1761947175615,"version":"build-2065373602"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2003,5,19]],"date-time":"2003-05-19T00:00:00Z","timestamp":1053302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2003,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Cryosurgery is an adjuvant surgical technique for the treatment of benign aggressive, low\u2010grade malignant and metastatic tumors of long bones. It has been used rarely to treat sacral tumors, mainly because of potential damage to nerves, blood vessels, and intrapelvic organs. The authors described their experience with this procedure and provided medium and long\u2010term follow\u2010up results.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Fifteen procedures of cryosurgery of the sacrum were performed in 14 patients to improve the therapeutic outcome of a variety of tumors. The patient group included 7 males and 7 females with a mean age of 42 \u00b1 24 years. Three patients were younger than 20 years of age. The procedures were performed at the Tel Aviv Sourasky Medical Center between January 1991 and January 1999. There were seven benign aggressive lesions (four giant cell tumors and three aneurysmal bone cysts), one benign schwannoma, one low\u2010grade chondrosarcoma, five metastatic carcinomas, and one high\u2010grade Ewing sarcoma, all localized at level S<jats:sub>2<\/jats:sub> or higher. Eight of the bone tumors also involved significant anterior or posterior soft tissue. All patients had severe preoperative pain radiating to the buttocks, perineum, and lower limbs and 9 (64%) patients had bladder and\/or rectal dysfunction. Invasive diagnostic procedures and radiation (if warranted) preceded surgery. Sacral posterior fenestration and burr drilling were followed by two\u2010cycle cryosurgery using the open pour technique or the argon\u2010helium\u2013based heat\u2010freeze system.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>All interventions were performed under combined general and regional anesthesia and concluded uneventfully with moderate blood loss. Thirteen patients were discharged home after 8 \u00b1 5 days (one patient remained hospitalized for 30 days). Only two patients experienced local disease recurrence during a 3\u201311\u2010year follow\u2010up period: one was retreated successfully by cryosurgery and the other underwent sacrectomy and radiotherapy elsewhere, with a subsequent loss of visceral functions. No patient suffered chronic pain, deep wound infections, or significant neurologic deficits and all were satisfied with the esthetic outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Cryosurgery is a conservative, feasible, and safe adjuvant technique in the treatment of sacral tumors. It is associated with minimal permanent neurologic and vascular injury compared with sacrectomy. Cancer 2003;97:2830\u20138. \u00a9 2003 American Cancer Society.<\/jats:p><jats:p>DOI 10.1002\/cncr.11383<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.11383","type":"journal-article","created":{"date-parts":[[2003,5,21]],"date-time":"2003-05-21T06:01:27Z","timestamp":1053496887000},"page":"2830-2838","source":"Crossref","is-referenced-by-count":52,"title":["Role of adjuvant cryosurgery in intralesional treatment of sacral tumors"],"prefix":"10.1002","volume":"97","author":[{"given":"Yehuda","family":"Kollender","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Issac","family":"Meller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Bickels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon","family":"Flusser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josefin","family":"Issakov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ofer","family":"Merimsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nissim","family":"Marouani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Nirkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avi A.","family":"Weinbroum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,5,19]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.174.2.1740417"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19940815)74:4<1253::AID-CNCR2820740412>3.0.CO;2-9"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19861115)58:10<2348::AID-CNCR2820581032>3.0.CO;2-I"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200012000-00023"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67016-4"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)38799-0"},{"key":"e_1_2_6_8_2","first-page":"135","volume-title":"Musculoskeletal cancer surgery. Treatment of sarcomas and allied diseases","author":"Bickels J","year":"2001"},{"key":"e_1_2_6_9_2","first-page":"67","article-title":"Cryosurgery\u2014a review of recent advances and current issues","volume":"23","author":"Gage AA","year":"2002","journal-title":"Cryoletters."},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199902000-00019"},{"key":"e_1_2_6_11_2","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/00003086-198203000-00035","article-title":"A 17\u2010year review of cryosurgery in the treatment of bone tumors","volume":"163","author":"Marcove RC","year":"1982","journal-title":"Clin Orthop."},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197803)41:3<957::AID-CNCR2820410325>3.0.CO;2-Y"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199408000-00015"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.14.1076"},{"key":"e_1_2_6_15_2","unstructured":"MellerI NirkinA KollenderY.The CRYO\u2010HIT system: a new device for cryosurgery of bones: characteristics technique and advantages by a series of the first 20 cases[abstract]. Proceedings of the 10th International Symposium of Limb Salvage Cairns Australia April 11\u201314 1999:60a."},{"key":"e_1_2_6_16_2","unstructured":"BickelsJ WittingJC KollenderY MalawerMM MellerI.Cryosurgical ablation of bone tumors with argon probes[abstract]. Proceedings of the 11th International Symposium of Limb Salvage Birmingham October 10\u201312 UK 2001:123a."},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.196.9.770"},{"key":"e_1_2_6_18_2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/00003086-198801000-00038","article-title":"The effect of cryosurgery and polymethylmethacrylate in dogs with experimental bone defects comparable to tumor defects","volume":"226","author":"Malawer MM","year":"1988","journal-title":"Clin Orthop."},{"key":"e_1_2_6_19_2","first-page":"583","volume-title":"Musculoskeletal cancer surgery. 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Proceedings of the 10th International Symposium of Limb Salvage Cairns Australia April 11\u201314 1999:53a."},{"key":"e_1_2_6_23_2","first-page":"52","article-title":"Cryosurgery in osteogenic sarcoma: report of three cases","volume":"10","author":"Marcove RC","year":"1984","journal-title":"Compr Ther."}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.11383","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.11383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T08:45:53Z","timestamp":1760258753000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.11383"}},"subtitle":["<i>Results of a 3\u201311\u2010year follow\u2010up<\/i>"],"short-title":[],"issued":{"date-parts":[[2003,5,19]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2003,6]]}},"alternative-id":["10.1002\/cncr.11383"],"URL":"https:\/\/doi.org\/10.1002\/cncr.11383","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"type":"print","value":"0008-543X"},{"type":"electronic","value":"1097-0142"}],"subject":[],"published":{"date-parts":[[2003,5,19]]}}}