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Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation

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Abstract

Purpose

To assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.

Materials and Methods

24 patients (62.3 ± 13.2 year; range 32–80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 18FDG-PET/CT—positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher’s exact test and Mann–Whitney U test were used and Kaplan–Meier curve calculated.

Results

Technical success was obtained in all 46 lymph nodes (100 %). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 %) patients. Overall, local control was obtained in 40/46 (86.9 %) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 %) patients. Local control was achieved in 40/46 (86.9 %) lymph nodes at 1 year and in all of the 25 nodes (100 %) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.

Conclusion

Ultrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.

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Author information

Authors and Affiliations

  1. Division of Interventional Radiology, European Institute of Oncology, Milan, Italy

    Giovanni Mauri

  2. Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, 20097, San Donato Milanese, Milano, Italy

    Giovanni Mauri

  3. Unit of Interventional Oncology, General Hospital of Busto Arsizio, Busto Arsizio, Italy

    Luca Cova

  4. Unit of Interventional Radiology, IRCCS Istituto Clinico Humanitas, Rozzano, Italy

    Tiziana Ierace & Luigi Solbiati

  5. Department of Nuclear Medicine, General Hospital of Busto Arsizio, Busto Arsizio, Italy

    Alberto Baroli & Enzo Di Mauro

  6. Department of Diagnostic Imaging, Regina Apostolorum Hospital, Albano, Italy

    Claudio Maurizio Pacella

  7. Image-guided Therapy and Interventional Oncology Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel

    Shraga Nahum Goldberg

  8. Humanitas Research Hospital, Humanitas University, Milan, Italy

    Luigi Solbiati

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  1. Giovanni Mauri
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Corresponding author

Correspondence to Giovanni Mauri.

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Conflict of interest

Shraga Nahum Goldberg sponsored research Cosman Company, Research consultant Cosman Company, Angiodynamics, and XACT medical. Giovanni Mauri is a consultant for Esaote S.p.A. All the other authors have nothing to disclose.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Mauri, G., Cova, L., Ierace, T. et al. Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation. Cardiovasc Intervent Radiol 39, 1023–1030 (2016). https://doi.org/10.1007/s00270-016-1313-6

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  • DOI: https://doi.org/10.1007/s00270-016-1313-6

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