Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer
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To assess the efficacy and safety of ultrasound- (US) guided radiofrequency ablation (RFA) for controlling locoregional recurrent papillary thyroid cancer (PTC) in a large patient population.
We included patients who had undergone RFA for locoregional recurrent PTC between September 2008 and April 2012 who fulfilled the following criteria: no metastasis beyond the neck; not more than four tumours; confirmed recurrence by US-guided fine needle aspiration biopsy or thyroglobulin measurement of needle washouts; more than a six-month follow-up period; and surgery not feasible or was refused by the patient.
Sixty-one recurrent tumours in 39 patients were included. The mean follow-up duration was 26.4 ± 13.7 months. Tumour volume decreased significantly from 0.20 ± 0.35 ml before ablation to 0.02 ± 0.11 ml (P < .001), with a mean volume reduction ratio of 95.1 ± 12.3 %. Fifty tumours (82.0 %) completely disappeared. Eleven tumours were visible at last follow-up US. The mean serum thyroglobulin level decreased from 1.21 ± 1.91 to 0.50 ± 0.80 ng/ml (P = .001). The overall complication rate was 7.7 % (3/39).
RFA can effectively control locoregional recurrent PTC without life-threatening complications; therefore, RFA may replace “berry picking surgery” in selected patients.
• RFA for recurrent PTC achieved a volume reduction ratio of 95.1 ± 12.3 %
• Eighty-two percent (50/61) of recurrent PTC completely disappeared after RFA
• The mean serum thyroglobulin level decreased significantly (P = .001) after RFA
• RFA may replace “berry picking surgery” for recurrent PTC
KeywordsRadiofrequency ablation Recurrent thyroid cancer Ultrasound Thyroid Ethanol ablation
Papillary thyroid carcinoma
Fine needle aspiration biopsy
thyroglobulin measurement of needle washout
Volume reduction ratio
The scientific guarantor of this publication is Hyun Kwon Ha, head of the department of Radiology and Research institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, observational, performed at one institution.
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- 5.Hay ID, Bergstralh EJ, Goellner JR, Ebersold JR, Grant CS (1993) Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989. Surgery 114:1050–1057, discussion 1057–1058PubMedGoogle Scholar
- 9.Heilo A, Sigstad E, Fagerlid KH, Haskjold OI, Grøholt KK, Berner A, Bjøro T, Jørgensen LH (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 96:2750–2755PubMedCrossRefGoogle Scholar
- 13.Papini E, Bizzarri G, Bianchini A, Valle D, Misischi I, Guglielmi R, Salvatori M, Solbiati L, Crescenzi A, Pacella CM, Gharib H (2013) Percutaneous ultrasound-guided laser ablation is effective for treating selected nodal metastases in papillary thyroid cancer. J Clin Endocrinol Metab 98:E92–E97PubMedCrossRefGoogle Scholar
- 20.Deandrea M, Limone P, Basso E, Mormile A, Ragazzoni F, Gamarra E, Spiezia S, Faggiano A, Colao A, Molinari F, Garberoglio R (2008) US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. Ultrasound Med Biol 34:784–791PubMedCrossRefGoogle Scholar
- 25.Jeon SJ, Kim E, Park JS, Son KR, Baek JH, Kim YS, do Park J, Cho BY, Na DG (2009) Diagnostic benefit of thyroglobulin measurement in fine-needle aspiration for diagnosing metastatic cervical lymph nodes from papillary thyroid cancer: correlations with US features. Korean J Radiol 10:106–111PubMedCentralPubMedCrossRefGoogle Scholar
- 27.Goldberg SN, Charboneau JW, Dodd GD, Dupuy DE, Gervais DA, Gillams AR, Kane RA, Lee FT, Livraghi T, McGahan JP, Rhim H, Silverman SG, Solbiati L, Vogl TJ, Wood BJ (2003) Image-guided tumor ablation: proposal for standardization of terms and reporting criteria. Radiology 228:335–345PubMedCrossRefGoogle Scholar
- 29.Hay ID, Lee RA, Davidge-Pitts C, Reading CC, Charboneau JW (2013) Long-term outcome of ultrasound-guided percutaneous ethanol ablation of selected “recurrent” neck nodal metastases in 25 patients with TNM stages III or IVA papillary thyroid carcinoma previously treated by surgery and 131I therapy. Surgery 154:1448–1454PubMedCrossRefGoogle Scholar
- 32.Na DG, Lee JH, Jung SL, Kim JH, Sung JY, Shin JH, Kim EK, Lee JH, Kim DW, Park JS, Kim KS, Baek SM, Lee Y, Chong S, Sim JS, Huh JY, Bae JI, Kim KT, Han SY, Bae MY, Kim YS, Baek JH (2012) Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers:consensus statement and recommendations. Korean J Radiol 13:117–125PubMedCentralPubMedCrossRefGoogle Scholar