Thermal Ablation for Papillary Thyroid Microcarcinoma: How Far We Have Come?

Abstract

Purpose Thermal ablation (TA), as one of the most currently remarkable technologies, has achieved great success in many malignant diseases including but not limited to hepatic and renal carcinoma. In recent years, this technology was gradually introduced to the treatment of papillary thyroid microcarcinoma (PTMC) and even papillary thyroid carcinoma (PTC). Thereby, we summarized the current progress of TA development in the treatment of PTMC. Methods The latest relevant literature from the PubMed database with keywords “thermal ablation”, “papillary thyroid microcarcinoma”, “microwave ablation”, “radio-frequency ablation”, and “laser ablation”, among others, were comprehensively reviewed in this article. The follow-up outcomes of patients in these articles were analyzed. Results The efficacy and safety of TA including microwave ablation (MWA), laser ablation (LA), and radiofrequency ablation (RFA) in the treatment of PTC and PTC have been intensively studied. Based on existing clinical trials, the relatively long-term follow-up (range, from 6 to 64.2 months) results in MWA, LA, and RFA were satisfactory that tumor volume reduction rate (VRR) reached and even surpass 99%. Compared with routine surgery methods (total thyroidectomy and lobectomy), the incidence rate of complications was relatively lower and the recurrence rate of TA techniques was not statistically significant, whereas the operative time, blood loss, length of hospital stay, and hospital cost were significantly decreased. Conclusion TA presents the same satisfactory therapeutic effects but minimal postoperative trauma can significantly improve the patients’ quality of life. However, future larger sample, multicenter, and prospective randomized controlled trials are urgently needed to validate the feasibility of TA in dealing with PTMC.

The Role of CEUS in the Evaluation of Thyroid Cancer: From Diagnosis to Local Staging

“…In addition, the patients who received additional RFA achieved good therapeutic results during follow-up. However, in a recent study, compared with PTMC, PTC (diameter > 10 mm, T1bN0M0) patients who were enrolled to undergo the TA had a relatively higher residual lesion and LNM ratio (3.03%, two in 66 cases; 1.52%, one in 66 cases, respectively) [ 52 ].…”

Nanoparticles: Promising Auxiliary Agents for Diagnosis and Therapy of Thyroid Cancers

“…Thermal ablation for papillary microcarcinoma up to ≤1 cm in size is very common in China. Ablation is either performed by microwave, laser, or radiofrequency exposure, resulting in coagulation necrosis of the tumor cells [110]. Thermal ablation appears to result in satisfactory therapeutic effects with minimal postoperative trauma but bears the risk of damage of the surrounding issue.…”

Occupational exposure and radiobiological risk from thyroid radioiodine therapy in Saudi Arabia

“…The procedure is safe and effective in treating thyroid cancer. It provides innovative alternative therapy with minimal postoperative distress, shorter time of operation, and hospitalization stay, which can considerably increase the patients’ lives 8 . However, some complications were reported during MWA including, hoarseness, skin burning sensation, and haemorrhage 9 , 10 .…”

“…The main drawback of LA is the high temperature (≈ 110 °C), which could cause tissue burning, which may result in wound healing delay 11 . Radiofrequency ablation (RFA) has a comparable outcome with complications less than 4.5% 12 , with effective and safe treatment when surgical intervention cannot be executed 8 , 13 , 14 . High-Intensity Focused Ultrasound (HIFU) is used to eradicates tumours cells by thermal coagulation (≈ 60 °C) while sparing the superficial tissues 15 , with limited complications 16 .…”

“…The overall safety of the TA techniques is primary tumour location dependant. Operator experience was reported to be crucial in procedural complications 8 . However, in this study, all thyroid cancer patients underwent surgical operation (thyroidectomy) followed by radioiodine therapy as standard protocol 10 , 17 .…”