Ultrasound-guided thermal ablation for papillary thyroid microcarcinoma: a multicenter retrospective study

Abstract

Purpose: Ultrasound-guided thermal ablation (including microwave ablation [MWA] and radiofrequency ablation [RFA]) has emerged as a remarkable technology for the treatment of benign and malignant diseases. The objective of this multicenter study was to assess the efficacy and safety of thermal ablation in a large cohort of patients with papillary thyroid microcarcinoma (PTMC). Materials and methods: Retrospective study of 725 patients who underwent MWA/RFA at 11 centers between March 2015 and March 2020. The mean age of patients was 46 ± 11 years (range, 22-81); the mean follow-up time was 21 ± 13 months (range, 6-60). Changes in size of tumor, the rates of tumor disappearance, disease progression, and complications were assessed. Results: From 6 months post-ablation, the size of tumors was significantly reduced compared with those recorded pre-ablation (p < 0.001 for all). Five hundred and fifteen (71.0%) PTMCs had completely disappeared as assessed by ultrasound examination. Six (0.8%) patients developed disease progression post-ablation; of these, 5 (0.7%) patients developed new PTMCs, while one (0.1%) patient developed cervical lymph node metastasis. Nineteen (2.6%) patients developed complications post-ablation; of these 14 (1.9%) patients developed voice hoarseness, 4 (0.6%) developed hematoma, and one (0.1%) patient developed cough. Conclusions: Ultrasound-guided thermal ablation represents an effective and safe treatment for patients with PTMC besides active surveillance and surgery.

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

“…The 2015 ATA guidelines suggest that patients with low risk PTMCs can also be actively monitored (15); however, some patients are unable to undergo long-term follow-up because of anxiety about the disease, and in these cases, ablation of PTMC is a compromise between surgery and observation. A multicenter PTMC ablation study conducted in China that included 11 centers and 725 patients (21) showed a significant reduction in tumor size at 6 months after ablation compared with that before ablation. On ultrasound, 515 (71.0%) PTMCs disappeared completely.…”

“…In addition, the rich blood supply to the thyroid gland can lead to transient bleeding at the end of the ablation, although this can be relieved with compression. Finally, a small number of patients experience complications such as altered thyroid function (24,27,49,50,60,77) and cough (21,36,45) after thermal ablation, which normally resolve during the postoperative period.…”

Analysis of Therapeutic Effect and Influencing Factors of Ultrasound‐Guided Radiofrequency Ablation in the Treatment of Papillary Thyroid Microcarcinoma

“…25 Currently, treatment regimens for PTMC range from thyroidectomy, AS, and US-guided RFA. 5,8,15 Herein, the current study sought to evaluate the effects of US-guided RFA on PTMC and influencing factors, and the obtained findings revealed that US-guided RFA exhibits better efficacy, safety, and postoperative recovery and lower recurrence risk for PTMC treatment.…”

“…9 However, AS treatment is not suitable for all PTMC cases and some physicians hesitate to adopt the management policy in daily clinical practice. 10 The last decade has also witnessed the surge and adoption of US-guided ablation techniques such as laser ablation, 11 microwave ablation, [12][13][14] or radiofrequency ablation (RFA) 15 for successfully treating patients with benign thyroid nodules, PTMC, or metastatic lymph nodes at risk of surgery. Additionally, USguided RFA treatment is highly safe and effective for PTMC, and it can serve as a minimally invasive therapy for patients with PTMC who refuse AS or surgical treatment.…”

Changes in Thyroid Antibodies after Microwave Ablation of Thyroid Nodules

“…Microwave ablation (MWA) has been widely used in the treatment of benign thyroid nodules [ 5 ] and papillary thyroid cancer (PTC) [ 6 , 7 ]. Studies have demonstrated that MWA can preserve thyroid function in patients even with bilateral thyroid nodule ablation [ 8 ].…”