Efficacy and safety of ultrasound-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma in patients aged 55 years or older: a retrospective study

He, Haiyang; Song, Qing; Lan, Yu; Yan, Lin; Xiao, Jing; Zhang, Yan; Luo, Yukun

doi:10.1080/02656736.2021.1912416

Cited by 8 publications

(18 citation statements)

References 42 publications

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“…After careful selection of the articles, 15 studies were eligible for the final synthesis and were included in this review (eFigure 1 in the Supplement). Eleven articles potentially used overlapping patient cohorts based on author names, time period of patient inclusion, and affiliations …”

Section: Resultsmentioning

confidence: 99%

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Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid

Dijk

Coerts

Gunput

et al. 2022

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Papillary microcarcinomas of the thyroid (mPTCs) account for an increasing proportion of thyroid cancers in past decades. The use of radiofrequency ablation (RFA) has been investigated as an alternative to surgery. The effectiveness and safety of RFA has yet to be determined. OBJECTIVE To evaluate the effectiveness and safety of RFA for low-risk mPTC. DATA SOURCES Embase, MEDLINE via Ovid, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and the top 100 references of Google Scholar were searched from inception to May 28, 2021. STUDY SELECTION Articles reporting on adult patients with mPTC treated with RFA were included. Studies that involved patients with pre-ablation lymph node or distant metastases, recurrence of disease, or extrathyroidal extension were excluded. Final article selection was conducted by multiple reviewers based on consensus. The proportion of eligible articles was 1%.DATA EXTRACTION AND SYNTHESIS This meta-analysis was conducted in accordance with the MOOSE guidelines. Random and fixed-effect models were applied to obtain pooled proportions and 95% CIs. MAIN OUTCOMES AND MEASURESThe primary outcome was the complete disappearance rate of mPTC. Secondary outcomes were tumor progression and complications. RESULTSFifteen studies were included in this meta-analysis. A total of 1770 patients (1379 women [77.9%]; mean [SD] age, 45.4 [11.4] years; age range, 42.5-66.0 years) with 1822 tumors were treated with RFA; 49 tumors underwent 1 additional RFA session and 1 tumor underwent 2 additional RFA sessions. Mean (SD) follow-up time was 33.0 (11.4) months (range, 6-131 months). The pooled complete disappearance rate at the end of follow-up was 79% (95% CI, 65%-94%). The overall tumor progression rate was 1.5% (n = 26 patients), local residual mPTC in the ablation area was found in 7 tumors (0.4%), new mPTC in the thyroid was found in 15 patients (0.9%), and 4 patients (0.2%) developed lymph node metastases during follow-up. No distant metastases were detected. Three major complications occurred (2 voice changes lasting >2 months and 1 cardiac arrhythmia). Minor complications were described in 45 patients. CONCLUSIONS AND RELEVANCEThe findings of this systematic review and meta-analysis suggest that RFA is a safe and efficient method to treat selected low-risk mPTCs. Radiofrequency ablation could be envisioned as step-up treatment after local tumor growth under active surveillance for an mPTC or initial treatment in patients with mPTCs with anxiety about active surveillance.

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Section: Resultsmentioning

confidence: 99%

“…Twelve studies were case series (11 retrospective and 1 prospective), which are generally considered to have a high risk of bias and low certainty . Three studies were retrospective cohort studies .…”

Section: Resultsmentioning

confidence: 99%

Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid

Dijk

Coerts

Gunput

et al. 2022

JAMA Otolaryngol Head Neck Surg

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“…Patients treated with RFA had shorter hospital stays, blood loss, and residential expenses. RFA is also an effective alternative treatment for elderly patients (≥55 years) with PTMC 47 . Studies 32 also confirmed that RFA in the treatment of PTMC located in the isthmus had a therapeutic to similar to thyroidectomy.…”

Section: Resultsmentioning

confidence: 84%

“…RFA is also an effective alternative treatment for elderly patients (≥55 years) with PTMC. 47 Studies 32 also confirmed that RFA in the treatment of PTMC located in the isthmus had a therapeutic to similar to thyroidectomy. For bilateral or multifocal PTMC, there were no significant differences in recurrence or LNM after RFA compared to single PTMC.…”

Section: Application Of Rfa In the Treatment Of Ptmcmentioning

confidence: 79%

Ultrasound‐guided thermal ablation for papillary thyroid microcarcinoma: A systematic review

Zhang

2022

Clinical Endocrinology

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Objective Thyroidectomy is the first‐line treatment for papillary thyroid microcarcinoma (PTMC), but often involves aggressive overtreatment. Thermal ablation (TA) has been gradually used for the treatment of recurrent PTMC. However, it is not recommended for the treatment of primary PTMC according to the Korean and Italian guidelines. Therefore, this systematic review aimed to analyse the indications, efficacy, and safety of TA in the treatment of PTMC. Design Systematic review. Patients and Measurements A search strategy was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. A total of 27 articles were included in this study until January 2022. Results According to current guidelines and studies, we divided the indications of TA for PTMC into six primary and three secondary indications. Laser ablation (LA) has the advantages of a small needle, accurate output energy and precision ablation, and it is safe to important organs around the lesion. The patients recover quickly after radiofrequency ablation (RFA), with no major complications, recurrence, or lymph node metastasis. The volume reduction rate after RFA was the highest, followed by microwave ablation and LA, and the improvement in patient quality of life after TA was significantly better than after thyroidectomy. Conclusions TA is an effective alternative method for surgery in the treatment of low‐risk PTMC and has the advantages of being minimally invasive, economical, having less bleeding and having a high postoperative quality of life.

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“…Many studies have used 45 years as the cut-off point for staging (84)(85)(86). The 5-year survival rate of 65-year-old patients with PTMC who were not treated with surgery is 23% (87).. A clinical study analyzed the outcome and safety of PTMC thermal ablation in patients >55 years of age (68). The results showed that all nodules were completely ablated and the VPR at the last follow-up was 99.78 ± 1.54%; there were no serious complications.…”

Section: Agementioning

confidence: 99%

Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma

Chen

Tian

et al. 2022

Front. Oncol.

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BackgroundMinimally invasive treatment of thyroid tumors has become increasingly common, but has mainly focused on benign thyroid tumors, whereas thermal ablation of thyroid cancer remains controversial. Clinical studies analyzing the efficacy of thermal ablation of papillary thyroid carcinoma (PTC) have been conducted in several countries to verify its safety. Here, we screened and reviewed recent studies on the efficacy and safety of thermal ablation of PTC as well as psychological assessment, patient prognosis, recurrence, and factors affecting ablation.SummaryThe most significant controversy surrounding ablative treatment of PTC centers on its effectiveness and safety, and >40 studies have been conducted to address this issue. The studies include papillary thyroid microcarcinoma (PTMC) and non-PTMC, single PTC and multiple PTC, and controlled studies of ablative therapy and surgical treatment. In general, ablation techniques can be carefully performed and promoted under certain conditions and with active follow-up of postoperative patients. Ablation is a promising alternative treatment especially in patients who are inoperable.ConclusionsClinical studies on PTC ablation have provided new perspectives on local treatment. However, because PTC grows very slowly, it is an indolent tumor; therefore, studies with larger sample sizes and extended post-procedure follow-ups are necessary to confirm the investigators’ hypotheses.

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Efficacy and safety of ultrasound-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma in patients aged 55 years or older: a retrospective study

Cited by 8 publications

References 42 publications

Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid

Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid

Ultrasound‐guided thermal ablation for papillary thyroid microcarcinoma: A systematic review

Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma

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