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Percutaneous thermal ablation of lung metastases from thyroid carcinomas. A retrospective multicenter study of 107 nodules. On behalf of the TUTHYREF network

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Abstract

Purpose

To determine efficacy and safety of thermal ablation (TA) for the local treatment of lung metastases of thyroid cancer.

Methods

We retrospectively studied 47 patients from 10 centers treated by TA (radiofrequency, microwaves, and cryoablation) over 10 years. The endpoints were overall survival (OS), local efficacy, complications (CTCAE classification), and factors associated with survival. OS curves after first TA were built using the Kaplan–Meier method and compared with the log-rank test.

Results

A total of 107 lung metastases during 75 sessions were treated by radiofrequency (n = 56), microwaves (n = 9), and cryoablation (n = 10). Median follow-up time after TA was 5.2 years (0.2–13.3). OS was 93% at 2 years (95% confidence interval (CI): 86–94) and 79% at 3 years (95% CI: 66–91). On univariate and multivariate analysis with a Cox model, histology was the only significant factor for OS. OS at 3 years was 94% for follicular, oncocytic, or papillary follicular variant carcinomas, compared to 59% for papillary, medullary, insular or anaplastic carcinomas (P = 0.0001). The local control rate was 98.1% at 1 year and 94.8% at 2, 3, 4, and 5 years. Morbidity was low with no major complications (grade 4 and 5 CTCAE) and no complications in 29 of 75 sessions (38.7%).

Conclusions

TA is a useful, safe and effective option for local treatment of lung metastases from thyroid carcinoma. Prolonged OS was obtained, especially for lung metastases from follicular, oncocytic, or papillary follicular variant carcinomas. Achieving disease control with TA delays the need for systemic treatment.

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Data availability

Data are available upon reasonable request of the corresponding author F.B.

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Acknowledgements

The authors thank Pippa McKelvie-Sebileau for medical editing services. We thank Pippa McKelvie-Sebileau and Dorothée Quincy for help in drafting the paper.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Thyroid Oncology, Institut Bergonié, Bordeaux, France

    Françoise BONICHON & Yann Godbert

  2. Department of Interventional Radiology, Gustave-Roussy, Villejuif, France

    Thierry de BAERE

  3. Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy, Villejuif, France

    Amandine Berdelou & Sophie Leboulleux

  4. Department of Nuclear Medicine, Léon Bérard Center, Lyon, France

    Anne-Laure Giraudet

  5. Department of Radiology, Léon Bérard Center, Lyon, France

    Marie Cuinet

  6. Department of Endocrinology, Institut du Thorax, University Hospital, Nantes, France

    Delphine Drui

  7. Thoracic and General Radiology Department, University Hospital, Nantes, France

    Renan Liberge

  8. Department of Nuclear Medicine, Jean Perrin Center, Clermont Ferrand, France

    Antony Kelly

  9. Nuclear Medicine Service, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France

    Florence Tenenbaum

  10. Department of radiology, Hôpital Cochin, 27 rue du Faubourg St Jacques, 75014, Paris, France

    Paul Legmann

  11. Department of Endocrinology, University Hospital, Lille, France

    Christine Do Cao

  12. Unité Thyroïde Tumeurs Endocrines, Sorbonne Université, AP-HP Hôpital Pitié-Salpêtrière, Paris, France

    Laurence Leenhardt

  13. Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France

    Michel Toubeau

  14. Department of Radiology, Institut Bergonié, Bordeaux, France

    Jean Palussière

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  1. Françoise BONICHON
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Contributions

Study concepts: F.B., T.D.B., J.P.; Study Design: F.B., J.P.; Data acquisition: all authors; Quality control of data and algorithms: F.B.; Data analysis and interpretation: F.B., Y.G., J.P.; Paper preparation and editing: F.B., T.D.B., S.L.,Y.G., J.P.

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Correspondence to Françoise BONICHON.

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T.d.B. is consultant for: Medtronic, Galil, Boston-Scientific. J.P. is consultant for Boston scientific. All other authors declare that they have no conflict of interest.

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BONICHON, F., de BAERE, T., Berdelou, A. et al. Percutaneous thermal ablation of lung metastases from thyroid carcinomas. A retrospective multicenter study of 107 nodules. On behalf of the TUTHYREF network. Endocrine 72, 798–808 (2021). https://doi.org/10.1007/s12020-020-02580-2

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