Preliminary report of microwave ablation for the primary papillary thyroid microcarcinoma: a large-cohort of 185 patients feasibility study
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To assess the safety and efficacy of microwave ablation (MWA) for primary papillary thyroid microcarcinoma (PTMC) with a large sample of 185 patients.
A total of 185 patients underwent MWA for 206 primary PTMC nodules. They received ultrasound follow-up at 1, 3, 6, and 12 months after MWA and every 6 months thereafter. Nodule volumes were calculated at each follow-up and compared with those before MWA. Additionally, the volume reduction rate (VRR) of the nodules was calculated. Patients’ thyroid functions were tested before and 1 month after MWA.
The mean follow-up time of the 185 patients was 20.7 ± 8.8 months (range 12–36 months). During the follow-up period, the mean volume of the 206 nodules was 100.1 ± 92.9 mm3 (range 3.6–423.9) before MWA, which decreased to 2.2 ± 5.6 mm3 (range 0–20.3 mm3) after MWA (P = 0.000). The mean VRR of the nodules was 98.65 ± 3.60% after MWA (range 83.85–100%). One hundred and seventy four of 206 nodules (84.5%) were fully absorbed. Compared with the preoperative results, no significant variation in thyroid function was observed 1 month after MWA. Thirty-eight patients (20.5%) had different types of complications, ranging from minor to major. Five patients (2.7%) had hoarseness, 11 patients (5.9%) had bleeding, 21 patients (11.4%) had earache or toothache, and one patient had another lesion 1 month after MWA.
This preliminary study suggests that MWA is safe and effective in the treatment of primary PTMC and offers a new alternative for clinical treatment.
KeywordsThermal ablation Microwave Ultrasound Thyroid Papillary carcinoma
This study was funded by the Finance Department of Jilin Province (No. SCZSY201701), the Jilin Provincial Health and Family Planning Commission (NO. 2016ZC032) and Jilin Province Science and Technology Department (NO. 20170414042GH).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The studies have been approved by the appropriate institutional research ethics committee and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This manuscript does not contain any studies with animals by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 2.B. Aschebrook-Kilfoy, R.B. Schechter, Y.C. Shih, E.L. Kaplan, B.C. Chiu, P. Angelos, R.H. Grogan, The clinical and economic burden of a sustained increase in thyroid cancer incidence. Cancer Epidemiol. Biomark. Prev. 22(7), 1252–1259 (2013). https://doi.org/10.1158/1055-9965.epi-13-0242 CrossRefGoogle Scholar
- 4.Y. Ito, A. Miyauchi, H. Oda, Low-risk papillary microcarcinoma of the thyroid: A review of active surveillance trials. Eur. J. Surg. Oncol. (2017). https://doi.org/10.1016/j.ejso.2017.03.004
- 6.G.C. Haser, R.M. Tuttle, H.K. Su, E.E. Alon, D. Bergman, V. Bernet, E. Brett, R. Cobin, E.H. Dewey, G. Doherty, L.L. Dos Reis, J. Harris, J. Klopper, S.L. Lee, R.A. Levine, S.J. Lepore, I. Likhterov, M.A. Lupo, J. Machac, J.I. Mechanick, S. Mehra, M. Milas, L.A. Orloff, G. Randolph, T.A. Revenson, K.J. Roberts, D.S. Ross, M.E. Rowe, R.C. Smallridge, D. Terris, R.P. Tufano, M.L. Urken, Active surveillance for papillary thyroid microcarcinoma: new challenges and opportunities for the health care system. Endocr. Pract. 22(5), 602–611 (2016). https://doi.org/10.4158/ep151065.ra CrossRefGoogle Scholar
- 9.J. Yu, P. Liang, X.L. Yu, Z.G. Cheng, Z.Y. Han, X. Zhang, J. Dong, M.J. Mu, X. Li, X.H. Wang, US-guided percutaneous microwave ablation versus open radical nephrectomy for small renal cell carcinoma: intermediate-term results. Radiology 270(3), 880–887 (2014). https://doi.org/10.1148/radiol.13130275 CrossRefGoogle Scholar
- 11.J. Xu, H. Wu, Z. Han, J. Zhang, Q. Li, J. Dou, C. An, E. Qi, J. Yu, P. Liang, Microwave ablation of benign breast tumors: a prospective study with minimum 12 months follow-up. Int. J. Hyperth. 1–9 (2018). https://doi.org/10.1080/02656736.2018.1494340
- 14.Z. Cheng, Y. Che, S. Yu, S. Wang, D. Teng, H. Xu, J. Li, D. Sun, Z. Han, P. Liang, US-Guided Percutaneous Radiofrequency versus Microwave Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study. Sci. Rep. 7(1), 9554 (2017). https://doi.org/10.1038/s41598-017-09930-7 CrossRefGoogle Scholar
- 17.D. Teng, G. Sui, C. Liu, Y. Wang, Y. Xia, H. Wang, Long-term efficacy of ultrasound-guided low power microwave ablation for the treatment of primary papillary thyroid microcarcinoma: a 3-year follow-up study. J. Cancer Res. Clin. Oncol. 144(4), 771–779 (2018). https://doi.org/10.1007/s00432-018-2607-7 CrossRefGoogle Scholar
- 19.D. Teng, L. Ding, Y. Wang, C. Liu, Y. Xia, H. Wang, Safety and efficiency of ultrasound-guided low power microwave ablation in the treatment of cervical metastatic lymph node from papillary thyroid carcinoma: a mean of 32 months follow-up study. Endocrine 62(3), 648–654 (2018). https://doi.org/10.1007/s12020-018-1711-4 CrossRefGoogle Scholar
- 20.J.H. Kim, J.H. Baek, H.K. Lim, H.S. Ahn, S.M. Baek, Y.J. Choi, Y.J. Choi, S.R. Chung, E.J. Ha, S.Y. Hahn, S.L. Jung, D.S. Kim, S.J. Kim, Y.K. Kim, C.Y. Lee, J.H. Lee, K.H. Lee, Y.H. Lee, J.S. Park, H. Park, J.H. Shin, C.H. Suh, J.Y. Sung, J.S. Sim, I. Youn, M. Choi, D.G. Na, 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean J. Radiol. 19(4), 632–655 (2018). https://doi.org/10.3348/kjr.2018.19.4.632 CrossRefGoogle Scholar
- 21.Y. Guang, Y. Luo, Y. Zhang, M. Zhang, N. Li, Y. Zhang, J. Tang, 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(8), 1555–1562 (2017). https://doi.org/10.1007/s00432-017-2386-6 CrossRefGoogle Scholar
- 22.G. Mauri, L. Cova, T. Ierace, A. Baroli, E. Di Mauro, C.M. Pacella, S.N. Goldberg, L. Solbiati, Treatment of metastatic lymph nodes in the neck from papillary thyroid carcinoma with percutaneous laser ablation. Cardiovasc. Interv. Radiol. 39(7), 1023–1030 (2016). https://doi.org/10.1007/s00270-016-1313-6 CrossRefGoogle Scholar
- 24.L. Zhang, W. Zhou, W. Zhan, Y. Peng, S. Jiang, S. Xu, 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(8), 2476–2484 (2018). https://doi.org/10.1007/s00268-018-4500-6 CrossRefGoogle Scholar
- 25.R. Valcavi, S. Piana, G.S. Bortolan, R. Lai, V. Barbieri, R. Negro, Ultrasound-guided percutaneous laser ablation of papillary thyroid microcarcinoma: a feasibility study on three cases with pathological and immunohistochemical evaluation. Thyroid 23(12), 1578–1582 (2013). https://doi.org/10.1089/thy.2013.0279 CrossRefGoogle Scholar
- 26.E. Papini, R. Guglielmi, H. Gharib, I. Misischi, F. Graziano, M. Chianelli, A. Crescenzi, A. Bianchini, D. Valle, G. Bizzarri, Ultrasound-guided laser ablation of incidental papillary thyroid microcarcinoma: a potential therapeutic approach in patients at surgical risk. Thyroid 21(8), 917–920 (2011). https://doi.org/10.1089/thy.2010.0447 CrossRefGoogle Scholar
- 27.J.H. Kim, J.H. Baek, J.Y. Sung, H.S. Min, K.W. Kim, J.H. Hah, D.J. Park, K.H. Kim, B.Y. Cho, D.G. Na, Radiofrequency ablation of low-risk small papillary thyroidcarcinoma: preliminary results for patients ineligible for surgery. Int. J. Hyperth., 1–11 (2016). https://doi.org/10.1080/02656736.2016.1230893
- 29.D.G. Na, J.H. Lee, S.L. Jung, J.H. Kim, J.Y. Sung, J.H. Shin, E.K. Kim, J.H. Lee, D.W. Kim, J.S. Park, K.S. Kim, S.M. Baek, Y. Lee, S. Chong, J.S. Sim, J.Y. Huh, J.I. Bae, K.T. Kim, S.Y. Han, M.Y. Bae, Y.S. Kim, J.H. Baek, Radiofrequency ablation of benign Thyroid nodules and recurrent Thyroid cancers: Consensus statement and recommendations. Kor. J. Radiol. 13(2), 117–125 (2012). https://doi.org/10.3348/kjr.2012.13.2.117 CrossRefGoogle Scholar
- 30.B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M. Sawka, M. Schlumberger, K.G. Schuff, S.I. Sherman, J.A. Sosa, D.L. Steward, R.M. Tuttle, L. Wartofsky, 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), 1–133 (2016). https://doi.org/10.1089/thy.2015.0020 CrossRefGoogle Scholar