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Long-term outcomes of radiofrequency ablation for unifocal low-risk papillary thyroid microcarcinoma: a large cohort study of 414 patients

  • Ultrasound
  • Published:
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Abstract

Objectives

The purpose of this study was to evaluate the long-term efficacy and safety of radiofrequency ablation (RFA) for low-risk papillary thyroid microcarcinoma (PTMC) in a large population.

Methods

From June 2014 to December 2017, 414 patients (323 females, 91 males, mean age 43.56 ± 9.79 years, range 18–73 years) with unifocal low-risk PTMC confirmed by core-needle biopsy (CNB) were treated by RFA. Patients were followed up at 1, 3, 6, and 12 months and every 6–12 months thereafter by ultrasound and contrast-enhanced ultrasound (CEUS). The volume and the volume reduction ratio (VRR) were calculated. Recurrence and lymph node or distant metastasis were evaluated.

Results

The mean initial volume was 92.74 ± 83.43 mm3 (range 4.19–490.07 mm3), which decreased significantly to 1.37 ± 7.94 mm3 (range 0–67.97 mm3) at a mean follow-up time of 42.15 ± 11.88 months (range 24–69 months) with a mean VRR of 98.81 ± 6.41% (range 50–100%). No life-threatening or delayed complications occurred. After RFA, 366 tumors (88.41%) completely disappeared. The overall incidence of local tumor progression rate was 3.62%. Among them, one patient (0.24%) was diagnosed to have residual cancer by CNB and underwent additional RFA. Four patients (0.97%) developed metastatic lymph node, and 10 patients (2.42%) had recurrent PTMC. A total of 13 patients underwent additional RFA, and 11 lesions completely disappeared during the follow-up.

Conclusions

RFA is an effective and safety treatment for low-risk PTMC after a long-term follow-up period for a large cohort with careful patient enrollment evaluation.

Key Points

• Radiofrequency ablation is an effective and safe alternative for low-risk PTMC.

• The overall incidence of local tumor progression rate was low.

• No life-threatening or delayed complications occurred.

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Abbreviations

CEUS:

Contrast-enhanced ultrasound

CNB:

Core-needle biopsy

LA:

Laser ablation

MWA:

Microwave ablation

PTMC:

Papillary thyroid microcarcinoma

RFA:

Radiofrequency ablation

US:

Ultrasound

VRR:

Volume reduction rate

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Funding

This study has received funding from the National Natural Science Foundation of China (No. 81771834).

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Authors and Affiliations

  1. Medical School of Chinese PLA, No. 28 Fuxing Road, Haidian District, Beijing, China

    Lin Yan & Yukun Luo

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

    Lin Yan, Yu Lan, Jing Xiao, Lin Lin, Bo Jiang & Yukun Luo

  3. Health Management Center, The Second Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, China

    Lin Yan

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  1. Lin Yan
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Corresponding author

Correspondence to Yukun Luo.

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Guarantor

The scientific guarantor of this publication is 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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Institutional review board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Yan, L., Lan, Y., Xiao, J. et al. Long-term outcomes of radiofrequency ablation for unifocal low-risk papillary thyroid microcarcinoma: a large cohort study of 414 patients. Eur Radiol 31, 685–694 (2021). https://doi.org/10.1007/s00330-020-07128-6

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  • DOI: https://doi.org/10.1007/s00330-020-07128-6

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