Skip to main content
SpringerLink
Log in

Percutaneous Microwave Ablation of Metastatic Lymph Nodes from Papillary Thyroid Carcinoma: Preliminary Results

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Our purpose is to assess the effectiveness and safety of ultrasound-guided percutaneous microwave ablation (MWA) for lymph node metastases (LNMs) from papillary thyroid carcinomas (PTC).

Methods

In total, 14 patients with recurrent PTC were enrolled in this retrospective study. The vascularity within the ablation zone was evaluated by contrast-enhanced ultrasonography (CEUS) after MWA. Patients were followed up with measurement of the size and volume of tumor, serum thyroglobulin, and clinical evaluation at 7 days, 1, 3, 6 months, and every 6 months thereafter.

Results

Twenty-one LNMs were confirmed by biopsy and successfully treated by MWA in a single session. No incomplete ablation was detected by CEUS after treatment. The average largest diameter and volume of the tumors were reduced from 10.1 ± 4.7 mm (range, 3.1–20.0 mm) and 291.9 ± 255.6 mm3 (range, 11.6–766.6 mm3) to 0.9 ± 1.6 mm (range, 0–4.1 mm; p < 0.05) and 4.0 ± 9.0 mm3 (range, 0–31.6 mm3; p < 0.05) at the final follow-up. Neither progression of treated tumors nor newly suspicious LNMs could be detected after treatment. The overall complication rate was 7.1% (1/14).

Conclusions

Ultrasound-guided MWA can effectively control LNMs from PTC, but it is less safe for tumors in the central compartment. MWA may become an alternative therapy in selected PTC patients, who were ineligible or refused to undergo repeated neck explorations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

LNMs:

Lymph node metastases

PTC:

Papillary thyroid carcinoma

US:

Ultrasound

CEUS:

Contrast-enhanced ultrasonography

MWA:

Microwave ablation

FNAB:

Fine-needle aspiration biopsy

References

  1. Johnson NA, Tublin ME (2008) Postoperative surveillance of differentiated thyroid carcinoma: rationale, techniques, and controversies. Radiology 249:429–444

    Article  PubMed  Google Scholar 

  2. DeGroot LJ, Kaplan EL, McCormick M et al (1990) Natural history, treatment, and course of papillary thyroid carcinoma. J Clin Endocrinol Metab 71:414–424

    Article  PubMed  CAS  Google Scholar 

  3. Burman KD (2012) Treatment of recurrent or persistent cervical node metastases in differentiated thyroid cancer: deceptively simple options. J Clin Endocrinol Metab 97:2623–2625

    Article  PubMed  CAS  Google Scholar 

  4. Frasoldati A, Pesenti M, Gallo M et al (2003) Diagnosis of neck recurrences in patients with differentiated thyroid carcinoma. Cancer 97:90–96

    Article  PubMed  Google Scholar 

  5. Samaan NA, Schultz PN, Hickey RC et al (1992) The results of various modalities of treatment of well differentiated thyroid carcinomas: a retrospective review of 1599 patients. J Clin Endocrinol Metab 75:714–720

    PubMed  CAS  Google Scholar 

  6. Heilo A, Sigstad E, Fagerlid KH et al (2011) Efficacy of ultrasound-guided percutaneous ethanol injection treatment in patients with a limited number of metastatic cervical lymph nodes from papillary thyroid carcinoma. J Clin Endocrinol Metab 96:2750–2755

    Article  PubMed  CAS  Google Scholar 

  7. Zhou W, Zhang L, Zhan W et al (2016) Percutaneous laser ablation for treatment of locally recurrent papillary thyroid carcinoma < 15 mm. Clin Radiol 71:1233–1239

    Article  PubMed  CAS  Google Scholar 

  8. Zhang L, Zhou W, Zhan W (2018) Role of ultrasound in the assessment of percutaneous laser ablation of cervical metastatic lymph nodes from thyroid carcinoma. Acta Radiol 59:434–440

    Article  PubMed  Google Scholar 

  9. Kim JH, Yoo WS, Park YJ et al (2015) Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology 276:909–918

    Article  PubMed  Google Scholar 

  10. Li X, Liang P, Yu J et al (2013) Role of contrast-enhanced ultrasound in evaluating the efficiency of ultrasound guided percutaneous microwave ablation in patients with renal cell carcinoma. Radiol Oncol 47:398–404

    Article  PubMed  PubMed Central  Google Scholar 

  11. Qu P, Yu X, Liang P et al (2013) Contrast-enhanced ultrasound in the characterization of hepatocellular carcinomas treated by ablation: comparison with contrast-enhanced magnetic resonance imaging. Ultrasound Med Biol 39:1571–1579

    Article  PubMed  Google Scholar 

  12. Belfiore G, Ronza F, Belfiore MP et al (2013) Patients’ survival in lung malignancies treated by microwave ablation: our experience on 56 patients. Eur J Radiol 82:177–181

    Article  PubMed  CAS  Google Scholar 

  13. Yue W, Wang S, Yu S et al (2014) Ultrasound-guided percutaneous microwave ablation of solitary T1N0M0 papillary thyroid microcarcinoma: initial experience. Int J Hyperth 30:150–157

    Article  Google Scholar 

  14. Yue W, Chen L, Wang S et al (2015) Locoregional control of recurrent papillary thyroid carcinoma by ultrasound-guided percutaneous microwave ablation: a prospective study. Int J Hyperth 31:403–408

    Article  Google Scholar 

  15. Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133

    Article  PubMed  PubMed Central  Google Scholar 

  16. Robenshtok E, Fish S, Bach A et al (2012) Suspicious cervical lymph nodes detected after thyroidectomy for papillary thyroid cancer usually remain stable over years in properly selected patients. J Clin Endocrinol Metab 97:2706–2713

    Article  PubMed  CAS  Google Scholar 

  17. Rondeau G, Fish S, Hann LE et al (2011) Ultrasonographically detected small thyroid bed nodules identified after total thyroidectomy for differentiated thyroid cancer seldom show clinically significant structural progression. Thyroid 21:845–853

    Article  PubMed  Google Scholar 

  18. Guenette JP, Monchik JM, Dupuy DE (2013) Image-guided ablation of postsurgical locoregional recurrence of biopsy-proven well-differentiated thyroid carcinoma. J Vasc Interv Radiol 24:672–679

    Article  PubMed  Google Scholar 

  19. Guang Y, Luo Y, Zhang Y et al (2017) Efficacy and safety of percutaneous ultrasound guided radiofrequency ablation for treating cervical metastatic lymph nodes from papillary thyroid carcinoma. J Cancer Res Clin Oncol 143:1555–1562

    Article  PubMed  CAS  Google Scholar 

  20. Valcavi R, Riganti F, Bertani A et al (2010) Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid 20:1253–1261

    Article  PubMed  CAS  Google Scholar 

  21. Feng B, Liang P, Cheng Z et al (2012) Ultrasound-guided percutaneous microwave ablation of benign thyroid nodules: experimental and clinical studies. Eur J Endocrinol 166:1031–1037

    Article  PubMed  CAS  Google Scholar 

  22. Yue W, Wang S, Wang B et al (2013) Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients. Eur J Radiol 82:e11–16

    Article  Google Scholar 

  23. Dodd GD 3rd, Dodd NA, Lanctot AC et al (2013) Effect of variation of portal venous blood flow on radiofrequency and microwave ablations in a blood-perfused bovine liver model. Radiology 267:129–136

    Article  PubMed  Google Scholar 

  24. Qian GJ, Wang N, Shen Q et al (2012) Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies. Eur Radiol 22:1983–1990

    Article  PubMed  Google Scholar 

  25. Li C, Li C, Ge H et al (2018) Technical analysis of US imaging for precise microwave ablation for benign breast tumours. Int J Hyperth 34:1179–1185

    Article  Google Scholar 

  26. Baek JH, Kim YS, Sung JY et al (2011) Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. AJR Am J Roentgenol 197:W331–336

    Article  Google Scholar 

  27. Monchik JM, Donatini G, Iannuccilli J et al (2006) Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg 244:296–304

    Article  PubMed  PubMed Central  Google Scholar 

  28. Lee JH, Kim YS, Lee D et al (2010) Radiofrequency ablation (RFA) of benign thyroid nodules in patients with incompletely resolved clinical problems after ethanol ablation (EA). World J Surg 34:1488–1493. https://doi.org/10.1007/s00268-010-0565-6

    Article  PubMed  Google Scholar 

  29. Zhang L, Zhou W, Zhan W et al (2018) Percutaneous laser ablation of unifocal papillary thyroid microcarcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in assessing local therapeutic response. World J Surg 42:2476–2484

    Article  PubMed  Google Scholar 

  30. Uchida H, Imai T, Kikumori T et al (2013) Long-term results of surgery for papillary thyroid carcinoma with local recurrence. Surg Today 43:848–853

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

This work was supported by Grants from the Capacity building project of auxiliary department (Ultrasonic Medicine), clinical science and technology innovation project from Shanghai Shen Kang Hospital Development Center (No. SHDC22015006).

Author information

Authors and Affiliations

  1. Department of Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, 197 Ruijin 2 Rd, 200025, Shanghai, China

    Wei Zhou, Yudong Chen, Lu Zhang, Xiaofeng Ni, Shangyan Xu & Weiwei Zhan

Authors
  1. Wei Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yudong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaofeng Ni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shangyan Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Weiwei Zhan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Weiwei Zhan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhou, W., Chen, Y., Zhang, L. et al. Percutaneous Microwave Ablation of Metastatic Lymph Nodes from Papillary Thyroid Carcinoma: Preliminary Results. World J Surg 43, 1029–1037 (2019). https://doi.org/10.1007/s00268-018-04879-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-018-04879-8

Search

Navigation