Clinical outcomes of ultrasound-guided radiofrequency ablation for the treatment of primary papillary thyroid microcarcinoma

Ding, Min; Tang, Xianhui; Cui, Dan; Chi, Jiachang; Shi, Yaoping; Wang, Tong; Zhai, Bo; Li, P.

doi:10.1016/j.crad.2019.05.012

Cited by 58 publications

(51 citation statements)

References 23 publications

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“…Between the two studies with overlapping cohorts, the study with a larger sample size was chosen. Finally, 11 articles with a total of 715 patients with 748 primary PTMC were included (14)(15)(16)(17)(18)(19)(20)(22)(23)(24)(25). No additional eligible study was identified after a search of bibliographies within these articles.…”

Section: Literature Searchmentioning

confidence: 99%

“…The detailed characteristics of the 11 eligible studies are shown in Table 1. Among the 11 original articles included, there were 7 retrospective studies (14,15,(17)(18)(19)(20)25), 2 prospective studies (22,24), and 2 studies with unclear study design (16,23). All included studies were carried out in single centers.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The mean follow-up periods of included studies ranged from 7.8 to 25.7 months, with six studies reporting more than 1 year of mean follow-up periods (14,15,(18)(19)(20)25). The type of thermal ablation techniques included four MWA (14,18,22,23), four RFA (16,17,20,24), and three LA (15,19,25). The experience of operators was reported in seven studies (range, 2-20 years of experience).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The experience of operators was reported in seven studies (range, 2-20 years of experience). All study settings were based in Asian countries-10 in China (14)(15)(16)(17)(18)(19)(22)(23)(24)(25) and 1 in Korea (20). A single thermal ablation session was performed in four studies (14,15,20,22), while one study indicated a maximum of two LA sessions (19).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Recent studies have reported that thermal ablations are effective and safe for treating primary PTMC (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). However, there are still concerns and comprehensive assessment of thermal ablation techniques in terms of the treatment efficacy and safety of PTMC is necessary to optimize personalized care in the face of uncertain evidence and to bridge the evidence gaps in the future.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Thermal Ablation Techniques for the Treatment of Primary Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

Choi

Jung

2020

Thyroid

115

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Background: The increased incidence of primary papillary thyroid microcarcinoma (PTMC) has led to increased research in the field of nonsurgical therapeutic options for those who refuse surgery or are at high risk for surgery. The study aimed at comprehensively evaluating the efficacy and safety of thermal ablation techniques for the treatment of PTMC via a systematic review and meta-analysis. Methods: The Pubmed MEDLINE and EMBASE databases were searched for studies reporting the efficacy and safety of thermal ablations (radiofrequency-, laser-, and microwave-ablations [RFA, LA, and MWA]) until August 10, 2019. A review of 105 potential papers identified 11 eligible papers, including 715 patients. The pooled proportions of complete disappearance and recurrence, and the pooled estimates of mean volume reduction and its rate of the treated PTMC were assessed by using random-effects modeling. The pooled proportions of overall and major complications were calculated. Subgroup analysis was performed according to the treatment modality. Between-study heterogeneity was explored by using v 2 statistic for pooled estimates and inconsistency index I 2 . Quality of the studies was evaluated by using the Risk of Bias Assessment Tool for Nonrandomized Studies. Results: The pooled proportions of complete disappearance and recurrence of PTMC were 57.6% [95% confidence interval (CI): 35.4-79.8] and 0.4% [95% CI: 0-1.1], respectively. The pooled estimates of mean volume reduction and its rate were 73.5 mm 3 [52.4-94.6 mm 3 ] and 98.1% [95% CI: 96.7-99.5], respectively. The pooled proportions of overall and major complications were 3.2% [95% CI: 1.1-5.2] and 0.7% [95% CI: 0-1.5], respectively. Significant between-study heterogeneity was observed for complete disappearance ( p < 0.001, I 2 : 99%), mean volume reduction ( p < 0.001, I 2 : 93%), and its rate ( p < 0.001, I 2 : 86%). Subgroup analysis revealed heterogeneity of the complete disappearance proportion among the treatment modality (I 2 range: 95-100%). RFA showed the highest mean volume reduction rate (99.3%), followed by MWA (95.3%) and LA (88.6%) ( p < 0.001). Conclusions: All thermal ablation techniques were effective and safe for the treatment of PTMC. However, each treatment modality had significant heterogeneity with respect to complete disappearance of PTMC. Compared with RFA and MWA, LA was less effective in reducing the volume of PTMC.

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Section: Literature Searchmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Thermal Ablation Techniques for the Treatment of Primary Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

Choi

Jung

2020

Thyroid

115

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Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid

Dijk

Coerts

Gunput

et al. 2022

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Papillary microcarcinomas of the thyroid (mPTCs) account for an increasing proportion of thyroid cancers in past decades. The use of radiofrequency ablation (RFA) has been investigated as an alternative to surgery. The effectiveness and safety of RFA has yet to be determined. OBJECTIVE To evaluate the effectiveness and safety of RFA for low-risk mPTC. DATA SOURCES Embase, MEDLINE via Ovid, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and the top 100 references of Google Scholar were searched from inception to May 28, 2021. STUDY SELECTION Articles reporting on adult patients with mPTC treated with RFA were included. Studies that involved patients with pre-ablation lymph node or distant metastases, recurrence of disease, or extrathyroidal extension were excluded. Final article selection was conducted by multiple reviewers based on consensus. The proportion of eligible articles was 1%.DATA EXTRACTION AND SYNTHESIS This meta-analysis was conducted in accordance with the MOOSE guidelines. Random and fixed-effect models were applied to obtain pooled proportions and 95% CIs. MAIN OUTCOMES AND MEASURESThe primary outcome was the complete disappearance rate of mPTC. Secondary outcomes were tumor progression and complications. RESULTSFifteen studies were included in this meta-analysis. A total of 1770 patients (1379 women [77.9%]; mean [SD] age, 45.4 [11.4] years; age range, 42.5-66.0 years) with 1822 tumors were treated with RFA; 49 tumors underwent 1 additional RFA session and 1 tumor underwent 2 additional RFA sessions. Mean (SD) follow-up time was 33.0 (11.4) months (range, 6-131 months). The pooled complete disappearance rate at the end of follow-up was 79% (95% CI, 65%-94%). The overall tumor progression rate was 1.5% (n = 26 patients), local residual mPTC in the ablation area was found in 7 tumors (0.4%), new mPTC in the thyroid was found in 15 patients (0.9%), and 4 patients (0.2%) developed lymph node metastases during follow-up. No distant metastases were detected. Three major complications occurred (2 voice changes lasting >2 months and 1 cardiac arrhythmia). Minor complications were described in 45 patients. CONCLUSIONS AND RELEVANCEThe findings of this systematic review and meta-analysis suggest that RFA is a safe and efficient method to treat selected low-risk mPTCs. Radiofrequency ablation could be envisioned as step-up treatment after local tumor growth under active surveillance for an mPTC or initial treatment in patients with mPTCs with anxiety about active surveillance.

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Interventional Endocrinology: Techniques, Indications, and Potential Complications

Collins,

Kuo

2024

Contemporary Surgical Clerkships

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Clinical outcomes of ultrasound-guided radiofrequency ablation for the treatment of primary papillary thyroid microcarcinoma

Cited by 58 publications

References 23 publications

Efficacy and Safety of Thermal Ablation Techniques for the Treatment of Primary Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

Efficacy and Safety of Thermal Ablation Techniques for the Treatment of Primary Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid

Interventional Endocrinology: Techniques, Indications, and Potential Complications

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