Percutaneous laser ablation for benign and malignant thyroid diseases

Mauri, Giovanni; Nicosia, Luca; Vigna, Paolo Della; Varano, Gianluca Maria; Maiettini, Daniele; Bonomo, Guido; Giuliano, Gioacchino; Orsi, Franco; Solbiati, Luigi; Fiori, Elvio De; Papini, Enrico; Pacella, Claudio Maurizio; Sconfienza, Luca Maria

doi:10.14366/usg.18034

Cited by 44 publications

(34 citation statements)

References 69 publications

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“…There are a few other minimally invasive image-guided thermal ablation techniques for treating recurrent thyroid cancers, such as laser and microwave ablation. Laser ablation has been shown to yield good therapeutic results for both recurrences and incidental papillary thyroid microcarcinoma [10,37]. Similarly, microwave ablation showed promise for treating cervical metastatic lymph nodes from papillary thyroid carcinomas [12].…”

Section: Discussionmentioning

confidence: 99%

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Choi

Jung

Bae

et al. 2019

International Journal of Hyperthermia

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2019) Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study, International ABSTRACT Purpose: To compare the efficacy and complication rates of radiofrequency ablation (RFA) and repeat surgery in the treatment of locally recurrent thyroid cancers. Materials and methods: A total of 221 patients with locally recurrent thyroid cancers who underwent either RFA (n ¼ 96) or repeat surgery (n ¼ 125) between March 2008 and March 2017 were retrospectively enrolled (range of follow-up, 1-10 years). Each cohort consisted of 70 patients after propensity score adjustment. Patients with more than three recurrent lesions were excluded. The primary and secondary end points were recurrence-free survival and complication rates, respectively. Recurrence-free survival curves were compared via the logrank test. The complications-voice changes, hypocalcemia, and immediate procedural complications-were compared between the groups. In addition, pretreatment serum thyroglobulin (T g ) levels and those at the last follow-up were also compared between the two groups to examine therapeutic efficacy. Results: After propensity score matching, both groups showed no significant differences in baseline characteristics. The recurrence-free survival rates were comparable between the RFA and surgery groups (p ¼ .2). There were no significant differences in mean serum T g levels and their mean decrease after treatment between the groups (p ¼ .891 and p ¼ .963, respectively). Immediate procedural complications and voice changes also showed no significant between-group differences (p ¼ .316, p ¼ .084, respectively). Hypocalcemia occurred only in the repeat surgery group (n ¼ 18). Overall complications were significantly more frequent in the repeat surgery group (RFA, n ¼ 7; surgery, n ¼ 27; p < .001). Conclusion: RFA may be an effective and safe alternative to repeat surgery in the treatment of a small number of locally recurrent thyroid cancers. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Choi

Jung

Bae

et al. 2019

International Journal of Hyperthermia

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“…Therapeutic options other than observation and immediate surgery include percutaneous ethanol injection therapy and laser and radiofrequency ablation, which may be used to control primary microPTC in selected patients with reduced invasiveness, a low complication rate, and maintenance of gland function 34–38 . Evidence is, however, still limited.…”

Section: Management Of Papillary Thyroid Microcarcinomamentioning

confidence: 99%

“…radiofrequency ablation, which may be used to control primary microPTC in selected patients with reduced invasiveness, a low complication rate, and maintenance of gland function. [34][35][36][37][38] Evidence is, however, still limited.…”

mentioning

confidence: 99%

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

Ramundo

Sponziello

Falcone

et al. 2020

Journal of Surgical Oncology

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The incidence of papillary thyroid microcarcinoma (microPTC) has dramatically increased in the last decades. Most of these tumors remain small and clinically “silent”, only small number progress. Although thyroid surgery used to be the only therapeutic approach, recent guidelines now consider active surveillance for low‐risk microPTC. For this reason, more accurate risk stratification of microPTC is needed. The optimal management of low‐risk microPTC through accurate risk stratification represents a major clinical issue.

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“…Alternatively, differences in technique may be responsible for the differences in results achieved. For example, it is wellknown that parathyroid cells have the capacity to grow and replicate [26,27]. Persistence of even a few adenomatous parathyroid cells after ablation might result in suboptimal efficacy of ablation and require more treatment sessions.…”

Section: Discussionmentioning

confidence: 99%

US-guided laser treatment of parathyroid adenomas

Appelbaum

Goldberg

Ierace

et al. 2020

International Journal of Hyperthermia

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Objective: To determine the clinical efficacy of laser ablation for the tredatment of primary hyperparathyroidism (pHPT). Materials and methods: Twelve patients with pHPT were treated with laser ablation. Energy was administered by means of 1.5 m optical fibers percutaneously placed into the target via 21 G needles. A laser ablation unit (EchoLaser X4, Esaote) applied 3 W power for 400-600 s/fiber/insertion to a total 3600-9000 Joules of energy. Patient serum parathyroid hormone (PTH) and calcium levels were checked at baseline and thereafter every 6 months. Patients were followed-up for 2 years with serologic and contrast-enhanced ultrasound. Therapeutic success was defined as normal PTH and calcium levels together with disappearance of nodule-related symptoms. Results: All procedures were performed in single session. Immediately following ablation, contrast enhanced ultrasound confirmed that all but one target had become avascular (technical success rate 11/12; 92%), remaining avascular at all follow-up ultrasound examinations, thereafter. The mean volume of parathyroid nodules decreased from 0.54 cc to 0.36 cc (72.0%). Serum PTH and calcium levels were significantly lower at 1, 12 and 24 m compared to baseline (p < 0.01). By 6 m, PTH and calcium returned to normal and were stable until 24 m in all successfully treated patients. All cases of hyperparathyroid-related symptoms resolved by 6 m (ostealgia [n ¼ 5], repeated renal colic [n ¼ 5], vomiting [n ¼ 3]). Only one patient (8%) reported transient dysphonia as a minor complication. Conclusion: Laser ablation of enlarged, symptomatic parathyroid glands is safe and well-tolerated and can produce long-term, sustained reduction of serum PTH and calcium levels.

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Percutaneous laser ablation for benign and malignant thyroid diseases

Cited by 44 publications

References 69 publications

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

US-guided laser treatment of parathyroid adenomas

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