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Rigorous radiofrequency ablation can completely treat low-risk small papillary thyroid carcinoma without affecting subsequent surgical management

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Abstract

Objective

Minimally invasive therapies are gaining interest because of the indolence and excellent prognosis of low-risk papillary thyroid carcinoma (PTC). This study aimed to evaluate the outcomes of radiofrequency ablation (RFA) for low-risk PTC and to determine the effects of ablation on subsequent surgical management.

Methods

A medical record review was conducted including patients with low-risk PTC who underwent surgery after RFA from July 2015 to July 2021. Demographic characteristics, tumor characteristics, ablation procedures, surgical findings, and pathological changes were reviewed for all patients. The primary outcomes were surgical and pathological changes in post-ablation patients.

Results

Of the 10 patients with 11 PTCs, 9 (90%) were women; the median (SD) patient age was 41.5 (8.2) years. The maximum diameter range of PTCs was 3.0−12.0 mm. All 10 patients underwent rigorous RFA procedure involving a four-step approach, and had received surgical management. Intraoperatively, no patients had muscle and nerve injuries, and mild adhesion of the post-ablation lesions with the anterior cervical muscle was observed in two cases. Histopathologically, no residual PTCs were observed in the ablated areas in all patients. Central lymph node metastasis (LNM) was found in three (30.0%, pN1a). Occult PTCs were observed in three cases (30.0%).

Conclusions

Our findings suggest that low-risk small PTCs can be completely treated with rigorous RFA, which does not affect subsequent surgical management, if necessary. RFA may be a treatment option, but occult PTCs and clinically negative LNMs may be overlooked. Long-term follow-up data are necessary to further identify its efficacy.

Key points

• RFA can completely treat low-risk small PTC.

• RFA does not affect the subsequent surgical management if necessary.

• Because occult PTCs and clinically negative LNMs may be overlooked by RFA, long-term follow-up data are necessary to further identify its efficacy.

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Abbreviations

CEUS:

Contrast-enhanced ultrasonography

CNB:

Core needle biopsy

FNA:

Fine-needle aspiration

PTC:

Papillary thyroid carcinoma

RFA:

Radiofrequency ablation

US:

Ultrasound

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Funding

This study is supported by Beijing Municipal Science and Technology Commission (No. Z221100003522001).

Author information

Authors and Affiliations

  1. School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin, 300071, China

    Xinyang Li & Yukun Luo

  2. Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China

    Xinyang Li, Lin Yan, Jing Xiao, Yingying Li, Mingbo Zhang & Yukun Luo

  3. Department of Pathology, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China

    Jie Li

  4. Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China

    Zhi Qiao

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  1. Xinyang Li
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  4. Lin Yan
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Correspondence to Mingbo Zhang or Yukun Luo.

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The scientific guarantors of this publication are Mingbo Zhang and Yukun Luo.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

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Ethical approval was obtained from the Institutional Ethics Committee of the Chinese PLA General Hospital.

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• retrospective/observational study

• performed at one institution

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Li, X., Li, J., Qiao, Z. et al. Rigorous radiofrequency ablation can completely treat low-risk small papillary thyroid carcinoma without affecting subsequent surgical management. Eur Radiol 33, 4189–4197 (2023). https://doi.org/10.1007/s00330-022-09299-w

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  • DOI: https://doi.org/10.1007/s00330-022-09299-w

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