Efficacy and safety of ultrasonography-guided radiofrequency ablation for the treatment of T1bN0M0 papillary thyroid carcinoma: a retrospective study
Jing Xiao, Mingbo Zhang, Yan Zhang, Lin Yan, Yu Lan, Yaqiong Zhu, Ying Zhang, Lin Lin, Jie Tang, Yukun Luo
Abstract
Purpose To evaluate the efficacy and safety of ultrasonography (US)-guided radiofrequency ablation (RFA) for treating low-risk T1bN0M0 papillary thyroid cancer (PTC).Methods This retrospective study was approved by the ethics committee of the Chinese People’s Liberation Army General Hospital (S2019-211-01). Sixty-six patients with T1bN0M0 PTC (14 men and 52 women with a mean age of 41.0 ± 9.2 years [range, 21–61 years]), who were not eligible for or refused surgery, were included in our study. RFA was performed with the moving-shot technique, and the ablation area exceeded the tumor edge by at least 3 mm. US (including contrast-enhanced) was performed before RFA; 1, 3, and 6 months after RFA, and every 6 months thereafter. US-guided core-needle biopsy was performed 3 or 6 months after ablation to rule out recurrence.Results The technical success rate was 100%, and there were no major complications. The tumor volume decreased significantly; the volume reduction rate (VRR) was 99.11 ± 2.44% (range, 92.62–100%) at the final follow-up with 38 tumors (57.6%) disappearing. Significant decreases in the VRR were found at every other follow-up visit before 18 months (p < .01). Technique efficacy was obtained in 64/66 (97.0%) patients over 20.5 ± 7.4 months follow-up. Malignant cells were confirmed in 2 ablation zones (3.0%), and cervical lymph node metastasis was detected in 1 patient (1.5%). These patients underwent additional RFA and achieved good results.Conclusion RFA may be considered a safe and effective modality for the management of T1bN0M0 PTC in select patients.