Evaluation of Ultrasound-Guided Radiofrequency Ablation as a Treatment Option for Papillary Thyroid Microcarcinoma in the Isthmus: A Retrospective Study

Song, Qing; Gao, Hanjing; Tian, Xiaoqi; Ren, Ling; Lan, Yu; Yan, Lin; Luo, Yukun

doi:10.3389/fendo.2020.599471

Cited by 17 publications

(18 citation statements)

References 36 publications

(38 reference statements)

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“…However, whether PTC in the thyroid isthmus is an absolute contraindication to thermal ablation remains unclear. A clinical study enrolled 112 patients with PTC in the isthmus of the thyroid gland to analyze the effect of ablation treatment (82). The results showed that at 18 months after the procedure, the nodules disappeared at a rate of 100% and were even completely absorbed at 1 month after the procedure, although one patient had a recurrence at 7 months after the procedure.…”

Section: Ptc Located In the Isthmus Of The Thyroid Glandmentioning

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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Section: Ptc Located In the Isthmus Of The Thyroid Glandmentioning

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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“…A total of 41.7% and 95.8% of the nodules subsided within 6 months and 12 months after ablation, respectively, and there was no recurrence or LNM during follow‐up. The team conducted a large sample study in later stages 33,45,46 and confirmed there was no significant difference in recurrence rate, LNM or progression between RFA and surgery in the treatment of PTMC. Patients treated with RFA had shorter hospital stays, blood loss, and residential expenses.…”

Section: Resultsmentioning

confidence: 90%

“…However, an existing study confirmed the effectiveness and safety of ultrasound-guided RFA in the treatment of a single PTMC located in the isthmus. 33 Studies conducted by Yan et al 34,35 suggested that RFA in the treatment of multifocal and bilateral PTMC had similar effectiveness to that of unifocal PTMC, and suggested that RFA could be a promising alternative for patients with multifocal or bilateral PTMC who either refused or were not suitable for surgery.…”

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confidence: 99%

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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“…Following the improvement of resolution for ultrasound used in screening, there has been a trend of early and increased discovery for thyroid cancer, including PTCI (15). The lack of clarity regarding the optimal treatment approach has the unfortunate effect of delaying timely intervention.…”

Section: Introductionmentioning

confidence: 99%

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

Zhang¹,

Xu²,

Ge³

et al. 2021

Gland Surg

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Background: prognosis, identify clinicopathological characteristics, and determine optimal modalities for cT1N0M0 solitary papillary thyroid carcinoma in the isthmus (PTCI). Methods:The clinical data of 124 patients with cT1N0M0 solitary PTCI from 3 medical centers were analyzed retrospectively. Of these, 32 participants had undergone total thyroidectomy plus unilateral central neck dissection, 36 had received total thyroidectomy plus bilateral central neck dissection, 24 had lessthan-total thyroidectomy plus unilateral central neck dissection, and 32 had less-than-total thyroidectomy plus bilateral central neck dissection. We compared the effects of different surgical modalities and clinicopathological characteristics on the prognosis of cT1N0M0 solitary PTCI. Results: There was no significant difference in postoperative recurrence-free survival between participants who received different extents of central region lymph node dissection and thyroidectomies (P>0.05). Temporary hypocalcemia occurred in participants who underwent total thyroidectomy plus bilateral central neck dissection [chi-square (X2) =7.87, P=0.005]. Tumors with primary lesions ≥0.55 cm were prone to have central lymph node metastasis [95% confidence interval (CI): 0.51 to 0.71, P=0.047]. Multiple logistic analysis suggested that age over 55 years [odds ration (OR) =11.90, 95% CI: 1.36 to 104.03, P=0.025], tumor size greater than 0.55 cm (OR =4.16, 95% CI: 1.28 to 13.52, P=0.018), and absence of nodular goiter (OR =2.57, 95% CI: 1.05 to 6.32, P=0.04) were risk factors for central lymph node metastasis of patients with cT1N0M0 solitary PTCI.Conclusions: Less-than-total thyroidectomy is recommended for patients with cT1N0M0 solitary PTCI.Central lymph node dissection is recommended for patients who are prone to have central occult lymph node metastases with tumor size ≥55 cm, older than 55 years, and without nodular goiter.

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Evaluation of Ultrasound-Guided Radiofrequency Ablation as a Treatment Option for Papillary Thyroid Microcarcinoma in the Isthmus: A Retrospective Study

Cited by 17 publications

References 36 publications

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

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

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

Pathological analysis and surgical modalities selection of cT1N0M0 solitary papillary thyroid carcinoma in the isthmus

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