Thermal Ablation for Papillary Thyroid Microcarcinoma Located in The Isthmus: a Study With 3 Years Of Follow-Up

Zheng, Lin; Liu, Fangyi; Yu, Jie; Cheng, Zhigang; Yu, Xiaoling; Dong, Xiao-cong; Han, Zhiyu; Liang, Ping

doi:10.2217/fon-2021-0463

Cited by 7 publications

(1 citation statement)

References 41 publications

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“…Inadequate thermal Endocrine-Related Cancer e220244 coverage of the edges of the thyroid nodule can lead to the persistence of viable thyroid cells on the periphery and likely puts the patient at risk for a late recurrence (Hua et al 2021). With experience, improved technique, and appropriate use of hydrodissection, studies are emerging suggesting that nodules that are either abutting without invasion or <2 mm away from an intact thyroid capsule can also be safely and effectively ablated (Wu et al 2021, Zheng et al 2022.…”

Section: Percutaneous Ablation Technologies Currently Under Evaluationmentioning

confidence: 99%

Percutaneous ablation of low-risk papillary thyroid cancer

Tuttle

Ridouani

2023

Endocrine-Related Cancer

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Minimalistic management options such as active surveillance and thyroid lobectomy are increasingly being accepted as reasonable management options for properly selected patient with low-risk papillary thyroid cancer. Leveraging technologies developed for the treatment of benign thyroid nodules, ultrasound guided percutaneous thermal ablation is now being evaluated as a potential additional minimalistic management option for small, intrathyroidal, low-risk papillary thyroid cancer. Published retrospective data on more than 5,000 low risk papillary thyroid cancer patients treated with thermal ablation indicate that with appropriate training and proper patient selection these technologies can be safely and effectively applied to papillary microcarcinomas. When compared to immediate surgery, thermal ablation appears to have lower complication rates with similar short-term rates of recurrence. Proper patient selection is facilitated by use of a clinical framework which integrates imaging characteristics, patient characteristics, and medical team characteristics to classify a patient as ideal, appropriate, or inappropriate for minimalistic management options (active surveillance, thyroid lobectomy, or thermal ablation). While retrospective in nature and lacking randomized prospective clinical trial data, currently available data does support the proposition that thermal ablation technologies reliably destroy papillary thyroid microcarcinoma lesions and are associated with clinically acceptable oncologic outcomes when done by experienced teams in properly selected patients.

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Section: Percutaneous Ablation Technologies Currently Under Evaluationmentioning

confidence: 99%

Percutaneous ablation of low-risk papillary thyroid cancer

Tuttle

Ridouani

2023

Endocrine-Related Cancer

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Management of low-risk papillary thyroid cancer. Minimally-invasive treatments dictate a further paradigm shift?

Papini,

Guglielmi,

Novizio

et al. 2024

Endocrine

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Background Current management options for PTMC include lobo-isthmectomy and active surveillance (AS). Recently, ultrasound-guided minimally invasive procedures (MITs) are offered as a nonsurgical therapy for PTMC because they do not require hospitalization and general anaesthesia, and do not result in loss of thyroid function or cosmetic damage. MITs are reported to consistently provide, mostly in large retrospective series of patients, a rapid, safe, and cost-effective way to eradicate low-risk thyroid malignancies. However, conclusive data from well-conducted prospective studies on the histologically-proven completeness of tumor ablation and the long-term clinical advantages versus AS are still lacking. Objectives This study aimed to evaluate the efficacy and safety of ultrasound-guided minimally invasive treatments (MITs) for PTMC in comparison to traditional surgical methods and active surveillance, and to assess their role in current clinical practice. Methods A structured literature review was conducted using keywords related to PTMC, MIT, and comparative techniques. Studies were evaluated based on treatment modality, patient selection, follow-up duration, complication rates, and clinical outcomes. Results MITs have shown promising results in the management of PTMC. These treatments offer several advantages over surgery, such as reduced use of surgical resources, lower costs, minimal work disruption, and fewer major complications. However, there are still limitations, including the need for long-term surveillance and the potential risk of incomplete tumor ablation. Conclusions MITs represent a promising non-surgical option for managing low-risk PTMC, especially for patients ineligible for or refusing surgery. Despite favorable outcomes, more robust prospective data are needed to confirm their long-term benefits and completeness of tumor ablation. Interdisciplinary discussions and thorough patient education on the advantages and limitations of MITs are crucial for informed decision-making.

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