Xiao-Jing Cao1, Juan Liu2, Ya-Lin Zhu3, Lu Qi4, Geng Liu5, Hong-Ling Wang6, Zhong-Hua Wang7, Ying Zhou8, Jun-Feng He9, Jian-Qin Guo10, Li-Li Shi11, Mei Jian12, Aini Shataer6, Guo-Zhen Yan9, Zhen-Long Zhao1, Ying Wei1, Li-Li Peng1, Yan Li1, Ying Che3, Shu-Rong Wang2,4, Ming-An Yu1. 1. Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China. 2. Department of Thyroid, Beijing Beicheng Chinese Medicine Hospital, Beijing, China. 3. Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, China. 4. Department of Medical Ultrasound, Yantai Affliated Hospital of Binzhou Medical University, Yantai, China. 5. Department of Ultrasound, Wuhai People's Hospital, Wuhai, China. 6. Department of Breast and Thyroid Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China. 7. Special Inspection Section, Wendeng District People's Hospital, Weihai, China. 8. First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China. 9. Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, China. 10. Department of Interventional Ultrasound, Qinghai Provincial People's Hospital, Xining, China. 11. Department of Ultrasound, Laixi Municipal Hospital, Laixi, China. 12. Department of Ultrasound, Bayannur Hospital, Bayannur, China.
Abstract
BACKGROUND: Ultrasound-guided thermal ablation plays an important role in the management of thyroid disease. The objective of this study was to evaluate the feasibility, efficacy, and safety of thermal ablation for patients with solitary T1bN0M0 papillary thyroid carcinoma (PTC) who are ineligible for or unwilling to undergo surgery. MATERIALS AND METHODS: Data pertaining to 172 patients (38 males and 134 females) who received thermal ablation therapy at 12 hospitals between April 2015 and March 2020 were retrospectively analyzed. The mean duration of follow-up was 24.9 ± 14.1 months (range, 12-60). The technical feasibility, technical success, efficacy, and safety of treatment were analyzed. Postablation tumor size at various time points was compared with preablation measurement. RESULTS: All patients selected for thermal ablation received enlarged ablation, according to contrast-enhanced ultrasound postablation. The maximum diameter and volume of ablation zone at 6, 12, 18, 24, 36, and 48 months postablation were significantly smaller than those recorded preablation (P < 0.05 for all). At the most recent follow-up, 106 (61.6%) tumors had completely disappeared. The rate of lymph node metastasis was 0.6% (1/172) and the incidence of new tumors was 1.2% (2/172). The overall complication rate was 5.2% (9/172) (major complications: 4.6% [8/172]; minor complications: 0.6% [1/172]). All major complications were relieved within 4 months postablation. CONCLUSION: Thermal ablation may be a feasible, effective, and safe treatment option for patients with solitary T1bN0M0 PTC who are ineligible for or unwilling to undergo surgery. It may provide a novel treatment option for selected patients.
BACKGROUND: Ultrasound-guided thermal ablation plays an important role in the management of thyroid disease. The objective of this study was to evaluate the feasibility, efficacy, and safety of thermal ablation for patients with solitary T1bN0M0 papillary thyroid carcinoma (PTC) who are ineligible for or unwilling to undergo surgery. MATERIALS AND METHODS: Data pertaining to 172 patients (38 males and 134 females) who received thermal ablation therapy at 12 hospitals between April 2015 and March 2020 were retrospectively analyzed. The mean duration of follow-up was 24.9 ± 14.1 months (range, 12-60). The technical feasibility, technical success, efficacy, and safety of treatment were analyzed. Postablation tumor size at various time points was compared with preablation measurement. RESULTS: All patients selected for thermal ablation received enlarged ablation, according to contrast-enhanced ultrasound postablation. The maximum diameter and volume of ablation zone at 6, 12, 18, 24, 36, and 48 months postablation were significantly smaller than those recorded preablation (P < 0.05 for all). At the most recent follow-up, 106 (61.6%) tumors had completely disappeared. The rate of lymph node metastasis was 0.6% (1/172) and the incidence of new tumors was 1.2% (2/172). The overall complication rate was 5.2% (9/172) (major complications: 4.6% [8/172]; minor complications: 0.6% [1/172]). All major complications were relieved within 4 months postablation. CONCLUSION: Thermal ablation may be a feasible, effective, and safe treatment option for patients with solitary T1bN0M0 PTC who are ineligible for or unwilling to undergo surgery. It may provide a novel treatment option for selected patients.