Ji-Hoon Kim1, Jung Hwan Baek2, Jin Yong Sung3, Hye Sook Min4,5, Kyung Won Kim6, J Hun Hah7, Do Joon Park8, Kwang Hyun Kim9, Bo Youn Cho10, Dong Gyu Na11. 1. a Department of Radiology, Seoul National University Hospital , Jongno-gu , The Republic of Korea ; 2. b Department of Radiology, University of Ulsan College of Medicine, Asan Medical Centre , Seoul , The Republic of Korea ; 3. c Department of Radiology, Daerim St. Mary's Hospital , Seoul , The Republic of Korea ; 4. d Department of Pathology, Seoul National University Hospital , Jongno-gu , The Republic of Korea ; 5. e Department of Preventive Medicine, Seoul National University , Gwanak-gu , The Republic of Korea ; 6. f Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Centre , Seoul , The Republic of Korea ; 7. g Department of Otolaryngology ? Head and Neck Surgery, Seoul National University Hospital , Jongno-gu , The Republic of Korea ; 8. h Departrment of Internal Medicine, Seoul National University Hospital , Jongno-gu , The Republic of Korea ; 9. i Department of Otolaryngology ? Head and Neck Surgery, SMG-SNU Boramae Medical Centre , Seoul , The Republic of Korea ; 10. j Department of Internal Medicine, Chung Ang University Hospital , Seoul , The Republic of Korea ; 11. k Department of Radiology, Human Medical Imaging and Intervention Centre , Seoul , The Republic of Korea.
Abstract
PURPOSE: The purpose of this study is to retrospectively evaluate the outcomes of radiofrequency ablation (RFA) of low-risk small papillary thyroid carcinomas (PTCs) in patients who were ineligible for surgery. MATERIALS AND METHODS: Between 2005 and 2009, six PTCs (mean diameter, 0.92 cm; range, 0.6-1.3 cm) in six patients were treated with RFA by three radiologists in two hospitals. The inclusion criteria for this study were (1) pathologically confirmed PTC without cytological aggressiveness, (2) single PTC without extrathyroidal extension, (3) no metastatic tumours and (4) ineligibility for surgery. RFA was performed using a radiofrequency generator and an 18-gauge internally cooled electrode. The medical records were reviewed and analysed, focussing on the procedural profiles of RFA, symptoms and complications during and after RFA, and changes in tumours on follow-up ultrasonography. RESULTS: Before and after RFA, the results of thyroid function tests were normal in all patients. During 48.5 ± 12.3 months (range, 36-65 months) of follow-up, along with a significant reduction in the mean volume (98.5 ± 3.3%), four ablation zones (4/6, 66.7%) completely disappeared. Two ablation zones exhibited only small calcified residues with nearly complete disappearance of the corresponding non-calcified solid portions, and in one of them, malignant cells were absent as assessed by fine-needle aspiration and core-needle biopsy. Transient hypertension with mild headache (n = 1) and mild neck pain (n = 1) developed during the procedure and subsided without any treatment. CONCLUSION: Besides surgery and active surveillance, which are conflicting currently used management plans, RFA might represent an effective and a safe alternative for managing low-risk small PTCs, especially in patients ineligible for surgery.
PURPOSE: The purpose of this study is to retrospectively evaluate the outcomes of radiofrequency ablation (RFA) of low-risk small papillary thyroid carcinomas (PTCs) in patients who were ineligible for surgery. MATERIALS AND METHODS: Between 2005 and 2009, six PTCs (mean diameter, 0.92 cm; range, 0.6-1.3 cm) in six patients were treated with RFA by three radiologists in two hospitals. The inclusion criteria for this study were (1) pathologically confirmed PTC without cytological aggressiveness, (2) single PTC without extrathyroidal extension, (3) no metastatic tumours and (4) ineligibility for surgery. RFA was performed using a radiofrequency generator and an 18-gauge internally cooled electrode. The medical records were reviewed and analysed, focussing on the procedural profiles of RFA, symptoms and complications during and after RFA, and changes in tumours on follow-up ultrasonography. RESULTS: Before and after RFA, the results of thyroid function tests were normal in all patients. During 48.5 ± 12.3 months (range, 36-65 months) of follow-up, along with a significant reduction in the mean volume (98.5 ± 3.3%), four ablation zones (4/6, 66.7%) completely disappeared. Two ablation zones exhibited only small calcified residues with nearly complete disappearance of the corresponding non-calcified solid portions, and in one of them, malignant cells were absent as assessed by fine-needle aspiration and core-needle biopsy. Transient hypertension with mild headache (n = 1) and mild neck pain (n = 1) developed during the procedure and subsided without any treatment. CONCLUSION: Besides surgery and active surveillance, which are conflicting currently used management plans, RFA might represent an effective and a safe alternative for managing low-risk small PTCs, especially in patients ineligible for surgery.
Authors: Ralph P Tufano; Pia Pace-Asciak; Jonathon O Russell; Carlos Suárez; Gregory W Randolph; Fernando López; Ashok R Shaha; Antti Mäkitie; Juan P Rodrigo; Luiz Paulo Kowalski; Mark Zafereo; Peter Angelos; Alfio Ferlito Journal: Front Endocrinol (Lausanne) Date: 2021-06-24 Impact factor: 5.555