The Efficacy and Safety of Radiofrequency Ablation for Bilateral Papillary Thyroid Microcarcinoma

Yan, Lin; Zhang, Mingbo; Song, Qing; Xiao, Jing; Zhang, Ying; Luo, Yukun

doi:10.3389/fendo.2021.663636

Cited by 18 publications

(12 citation statements)

References 40 publications

(73 reference statements)

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“…According to the 8th AJCC/TNM Mortality Risk System and ATA Risk Stratification (14,94), bilateral PTMC is classified as stage I with a low risk of recurrence. The safety and efficacy of RFA for bilateral PTMC was analyzed in 47 cases (75). The results showed a complete disappearance rate of 92%, but recurrence was observed in two patients.…”

Section: Number Of Ptcsmentioning

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: Number Of Ptcsmentioning

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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“…Bilateral multifocality was more aggressive than unilateral multifocality, but it was not an independent prognosis factor ( 40 ). In 2021, one study preliminarily evaluated the efficacy and safety of RFA for 47 patients with 100 bilateral PTMCs, and the incidences of lymph node metastasis and recurrence were 2.13% and 4.26%, respectively ( 17 ), which were not higher than the currently known incidences ( 37 , 39 ). In this study, we included 7 (58.3%) patients with bilateral multifocal PTMCs.…”

Section: Discussionmentioning

confidence: 97%

“…Moreover, some studies with long-term follow-up revealed no significant differences in tumor size increase, lymph node metastasis, and extra-thyroidal invasion between unifocal and multifocal PTMC ( 35 , 36 ). Although the current guidelines for the thermal ablation of PTMC did not recommend ablation of multifocal PTMC, several studies had been conducted on the clinical outcomes of RFA for multifocal PTMC ( 16 , 17 ). A large cohort study evaluated the efficacy of RFA in 432 patients with unifocal PTMC and 55 patients with multifocal PTMC, and the results showed that multifocality had little effect on patient outcomes ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…The results of many studies on the role of multifocality in the clinical outcome of PTC were inconsistent and even contradictory ( 12 – 15 ). Several studies had been carried out on RFA for multifocal PTMC, and the results showed that RFA might be a promising treatment for both unifocal and multifocal PTMC ( 16 , 17 ). To the best of our knowledge, few studies about PLA for multifocal PTMC have been reported.…”

Section: Introductionmentioning

confidence: 99%

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The feasibility and efficacy of ultrasound-guided percutaneous laser ablation for multifocal papillary thyroid microcarcinoma

Zhang

Zhan

et al. 2022

Front. Endocrinol.

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ObjectiveThe aim of this study was to evaluate the feasibility and efficacy of percutaneous laser ablation (PLA) for patients with multifocal papillary thyroid microcarcinoma (PTMC).Materials and methodsA cohort of patients who underwent ultrasound (US)-guided PLA for primary PTMC were enrolled in this study. The patients were divided into a multifocal PTMC (multi-PTMC) group and a unifocal PTMC (uni-PTMC) group. Before PLA, conventional US and contrast-enhanced ultrasound (CEUS) were performed to evaluate the PTMC and cervical lymph nodes. The operation time, energy, power, amount of isolation liquid, and complications during PLA were recorded. Patients were followed up at 2 days, 1 month, 3 months, and 6 months, and every 6 months after that. Volume reduction rate (VRR), local tumor recurrence, and lymph node metastasis after PLA were observed.ResultsThe study included 12 patients with 26 PTMCs and 60 patients with 60 PTMCs. The operation time, total energy, and amount of isolation liquid in the multi-PTMC group were more than those in the uni-PTMC group (p = 0.000, 0.007, and 0.020, respectively). The mean follow-up durations in multi-PTMC and uni-PTMC groups were 19.75 ± 11.46 months (6–36 months) and 16.33 ± 10.01 months (4–40 months), with a similar VRR of the ablated lesions in the two groups. One and three cases with newly developed PTMCs were observed in the multi-PTMC group and the uni-PTMC group during follow-up, respectively. There was no regrowth of treated lesions, lymph node metastasis, or distant metastasis. At the end of the follow-up, all the ablated lesions in the two groups completely disappeared or only remained scar strips.ConclusionPLA is a safe and effective technique for treating multifocal PTMC, which might be an alternative technique for patients who are not eligible or are unwilling to undergo surgery.

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“…In PTMC with no evidence of extra thyroid expansion and lymph node metastasis, thermal ablation has become the main treatment for primary low-risk PTMC [ 31 – 33 ]. Compared with conventional surgery, thermal ablation significantly reduced the volume of primary tumor, had fewer postoperative complications, had a lower incidence of other serious complications, avoided complications related to general anesthesia, and achieved rapid recovery [ 5 , 32 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Economic effect between surgery and thermal ablation for patients with papillary thyroid microcarcinoma: a systemic review and meta-analysis

2022

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Background At present, there are still many controversies regarding the treatment of papillary thyroid microcarcinoma (PTMC). It is worth noting that thermal ablation has become a viable alternative for patients at high risk of surgery or those who wish to receive more active treatment than active surveillance. Objective To investigate the economic benefits, efficacy, and safety of thermal ablation for patients with PTMC. Methods We searched PubMed, Cochrane Library, Web of Science, and Embase for articles published from the database establishment to August 2021. All of the studies included were retrospective cohort analyses. In addition, meta-analysis was performed using the Stata15.1 versions and Review Manager5.3. Data were extracted according to the PRISMA guidelines by two professional doctors. Results A total of 7 articles (1582 patients) were included in our systematic review and meta-analysis. We discovered that thermal ablation could shorten the hospitalization time (SMD, −3.82[95%CI, −5.25 to −2.40]), operation time (SMD, −5.67[95%CI, −6.65 to −4.68]), cost (SMD, −3.40 [95%CI, −5.06 to −1.75]) and reduce postoperative complications (OR, 0.07 [95%CI, 0.01 to 0.44]) than surgical treatment. In addition, our study also found that compared with surgery, there was no significant difference in the recurrence rate (OR, 1.53 [95% CI, 0.63 to 3.73]) and metastasis rate (OR, 0.47 [95% CI, 0.12 to 1.86]). Conclusion On the premise of being safe and effective, thermal ablation has better economic benefits than surgical treatment for patients with PTMC.

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The Efficacy and Safety of Radiofrequency Ablation for Bilateral Papillary Thyroid Microcarcinoma

Cited by 18 publications

References 40 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

The feasibility and efficacy of ultrasound-guided percutaneous laser ablation for multifocal papillary thyroid microcarcinoma

Economic effect between surgery and thermal ablation for patients with papillary thyroid microcarcinoma: a systemic review and meta-analysis

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