Efficacy and Safety of Thermal Ablation for Solitary T1bN0M0 Papillary Thyroid Carcinoma: A Multicenter Study

Abstract

Background Ultrasound guided thermal ablation plays an important role in the management of thyroid disease. The objective of this study was to evaluate the feasibility, efficacy, and safety of thermal ablation for patients with solitary T1bN0M0 PTC who are ineligible for or unwilling to undergo surgery. Materials and Methods Data pertaining to 172 patients (38 males and 134 females) who received thermal ablation therapy at 12 hospitals between April 2015 and March 2020 were retrospectively analyzed. The mean duration of follow-up was 24.9 ± 14.1 months (range, 12–60). The technical feasibility, technical success, efficacy, and safety of treatment were analyzed. Post-ablation tumor size at various time-points was compared with pre-ablation measurement. Results All patients selected for thermal ablation received enlarged ablation according to contrast-enhanced ultrasound post-ablation. The maximum diameter and volume of ablation zone at 6,12, 18, 24, 36, and 48 months post-ablation were significantly smaller than those recorded pre-ablation (P < 0.05 for all). At the most recent follow-up, 106 (61.6%) tumors had completely disappeared. The rate of lymph node metastasis (LNM) was 0.6% (1/172) and the incidence of new tumor was 1.2% (2/172). The overall complication rate was 5.2% (9/172) (major complications: 4.6% [8/172]; minor complications: 0.6% [1/172]). All major complications were relieved within four months post-ablation. Conclusion Thermal ablation may be a feasible, effective, and safe treatment option for patients with solitary T1bN0M0 PTC who are ineligible for or unwilling to undergo surgery. It may provide a novel treatment option for selected patients.

Ultrasonography-guided radiofrequency ablation for the treatment of T2N0M0 papillary thyroid carcinoma: a preliminary study

“…A large cohort study with a mean follow-up of 42.15 months [14] has reported the efficacy of RFA in the treatment of PTMC with a mean VRR of 98.8%, and tumor disappearance rate of 88.41%. In addition, a multicenter study [23] on thermal ablation for the treatment of T1bN0M0 PTC showed a VRR of 99% at 48-month visit, and complete disappearance rate of 61.6% during a mean follow-up of 24.9 months. In the present study, the mean VRR at last follow-up (93.7%) was similar to those previous studies, but the disappearance rate (16.7%) was much lower.…”

“…In recent years, US-guided thermal ablation has been introduced to treat low risk PTC [17,22,23], and obtained excellent results. A large cohort study with a mean follow-up of 42.15 months [14] has reported the efficacy of RFA in the treatment of PTMC with a mean VRR of 98.8%, and tumor disappearance rate of 88.41%.…”

“…RFA has been recommended for the treatment of benign thyroid nodules and recurrent thyroid cancers by several guidelines and consensus statements [18][19][20][21]. Previous studies [22,23] reported that RFA for the treatment of T1N0M0 PTC achieved favorable results without major complications, and it was linked to a higher quality of life compared to surgery [24]. However, little research has been performed on the validity of RFA for the management of T2N0M0 PTC (i.e., PTC >2 cm and 4 cm without clinical evidence of local region and distant metastases).…”

Ultrasound-guided thermal ablation for papillary thyroid microcarcinoma: a multicenter retrospective study

“…Some ablation guidelines and consensus statements indicate that thermal ablation can be used in benign and selected malignant thyroid nodules [6][7][8][9][10]. For instance, microwave ablation (MWA), radiofrequency ablation (RFA), or laser ablation were introduced to treat low-risk T1a papillary thyroid carcinoma [11,12], and even T1b [13]. However, most of these studies were single-center studies with relatively small number of patients, and the results were sometimes inconsistent [14].…”

Ultrasound-Guided Radiofrequency Ablation Versus Surgical Resection for the Treatment of T1bN0M0 Papillary Thyroid Carcinoma in Different Age Groups

“…RFA is characterized by its technical ease and non-invasive nature. To date, several leading institutes have reported successful outcomes with the use of RFA in the treatment of T1N0M0 PTC, recurrent thyroid cancers, and lymph node metastatic tumors (17)(18)(19)(20)(21)(22). As compared to SR, RFA is associated with comparable long-term outcomes, shorter hospital stay, and fewer temporary and permanent complications (23,24).…”