Radiofrequency ablation and thyroid cancer: review of the current literature

Muhammad, Haris; Tehreem, Aniqa; Russell, Jonathon O.

doi:10.1016/j.amjoto.2021.103204

Cited by 11 publications

(8 citation statements)

References 42 publications

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“…This was consistent with findings that pressure (ie, coughing, neck pressure, twisting, or straining) and even mild insult to the nodule, such as fine-needle aspiration, may be associated with intranodular hemorrhage . Patient behaviors and body habitus may begin to play a larger role in the pathogenesis and outcomes of nodule rupture as the procedure gains traction across North America due to higher average body mass index values . Alternatively, rupture could be associated with having less subcutaneous fat and thus less insulating tissue, similar to those without isthmus tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Radiofrequency ablation (RFA) is a minimally invasive alternative to surgical thyroidectomy in the management of symptomatic benign thyroid nodules (BTNs). Thyroid RFA has been used in Asia and Europe since 2001 and is gaining traction worldwide . RFA of BTNs only achieved approval by the US Food and Drug Administration in 2018, and to our knowledge, reports from the North American experience are currently limited.…”

Section: Introductionmentioning

confidence: 99%

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Thyroid Nodule Rupture Following Radiofrequency Ablation for Benign Thyroid Nodules

Austerlitz,

Mann,

Noel

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceNodule rupture is a rare but serious complication of thyroid radiofrequency ablation (RFA). With growing adoption of thyroid RFA across the US, an understanding of thyroid nodule rupture (TNR) is crucial for recognition, management, and, ultimately, prevention.ObjectiveTo determine procedural and patient factors that may contribute to TNR and describe experiences in managing TNR while synthesizing existing literature.Design, Setting, and ParticipantsThis retrospective case series examined all RFA procedures for benign thyroid nodules performed by 2 attending physicians at a single academic referral center between December 2019 and January 2024. A total of 298 consecutive patients underwent RFA for benign thyroid nodules. Criteria for offering RFA included nodules with 2 benign fine-needle aspirations, no suspicious ultrasonography features, a greatest dimension of 2 cm or greater, compressive or cosmetic concerns, and accessibility to a straight needle.ExposuresAll RFAs were performed using ultrasonography guidance using the moving-shot technique and a 7-mm or 10-mm active tip.Main Outcomes and MeasuresThe primary outcome was TNR, and measures were procedure, nodule, and patient characteristics that may have contributed to its pathogenesis. Secondary outcomes were nodule volume reduction, thyroid function, and management and sequelae of TNR. The hypothesis on the pathogenesis of TNR was formed before data collection.ResultsSix of 298 patients (2%; 4 women [67%]) with a mean age of 48.5 years (range, 34-65 years) experienced TNR for a mean of 36 days postprocedure (range, 19-54 days). The mean (SD) initial nodule volume among patients with TNR was 31.45 (16.52) mL, and 3 of 6 patients (50%) underwent prior lobectomy. All ruptures were anterior. All patients were treated conservatively, and none required surgery. Five patients recovered completely; the sixth and most recent patient was healing as of last follow-up.Conclusions and RelevanceThere are limited data on the etiology and optimal management of TNR. These 6 cases of anterior rupture suggest that a potential contributor to TNR is thermal and mechanical trauma exerted at the fulcrum point during the moving-shot technique. The use of a smaller active tip (eg, 7 mm) and cessation of energy delivery before this point may help avoid TNR. More robust reporting of this complication may clarify risk factors for and enhance prevention of TNR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Thyroid Nodule Rupture Following Radiofrequency Ablation for Benign Thyroid Nodules

Austerlitz,

Mann,

Noel

et al. 2024

JAMA Otolaryngol Head Neck Surg

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“…RFA is not oncologically inferior to open surgery for carefully selected patients with low-risk intrathyroidal PTMC, and it is associated with a superior quality of life, lower complication rate, and reduced overall expenses 22 . Although RFA is a comparatively new technology, many studies and practiceshave shown that RFA is an alternative to surgery in patients with low-risk intrathyroidal PTMC 23 . However, the guidelines for the use of RFA are relatively brief and lack details, and doctors around the world need a clear consensus on the specific operation of RFA.…”

Section: Discussionmentioning

confidence: 99%

Important parameters should be paid attention in PTMC radiofrequency ablation

Dong,

Cheng,

Jin

et al. 2023

Sci Rep

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In order to provide clinical references for the RFA procedure and to study the pivotal factors affecting the recovery time of radiofrequency ablation (RFA) in patients with papillary thyroid microcarcinoma (PTMC), 176 patients with low-risk intrathyroidal PTMC were included in this research. We randomly divided the whole cohort into training and test groups at a ratio of 7:3. The two-sample t-test was used to detect differences between the two groups. Least absolute shrinkage and selection operator (LASSO) regression was used to select the best predictor variables for predicting the status of RFA zone. Multiple test methods were used to ensure the scientific nature and accuracy of the Cox proportional hazards model. We tested the performance for the parameters and revealed the best cut-off value of each variable by the ROC curve and log-rank tests. The results showed patients aged above 49 years old, with RFA energy above 2800 J, the average diameter of the original tumour above 0.6 cm, or the average diameter of ablation zone at 1 month after RFA above 1.1 cm are risk factors for RFA zone delayed healing.

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“…Recent reports have paid particular attention to RFA as a good alternative to traditional open thyroidectomy in the treatment of thyroid nodules, especially in high-risk patients. They indicated that patients suffer fewer complications, hospitalisation time is reduced, and the preservation of partial thyroid tissue reduces the need for postoperative hormone therapy [98]. RFA achieves similarly good results in the treatment of both benign lesions and indeterminate thyroid nodules [99].…”

Section: Thermal Ablationmentioning

confidence: 99%

Modern Surgical Techniques of Thyroidectomy and Advances in the Prevention and Treatment of Perioperative Complications

Ludwig,

Dziekiewicz

et al. 2023

Cancers

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Thyroid cancer is the most common cancer of the endocrine system, and, in recent years, there has been a phenomenon of overdiagnosis followed by subsequent overtreatment. This results in an increasing number of thyroidectomy complications being faced in clinical practice. In this paper, we present the current state of knowledge and the latest findings in the fields of modern surgical techniques, thermal ablation, the identification and assessment of parathyroid function, recurrent laryngeal nerve monitoring and treatment and perioperative bleeding. We reviewed 485 papers, from which we selected 125 papers that are the most relevant. The main merit of this article is its comprehensive view of the subject under discussion—both general, concerning the selection of the appropriate method of surgery, and particular, concerning the selection of the appropriate method of prevention or treatment of selected perioperative complications.

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Radiofrequency ablation and thyroid cancer: review of the current literature

Cited by 11 publications

References 42 publications

Thyroid Nodule Rupture Following Radiofrequency Ablation for Benign Thyroid Nodules

Thyroid Nodule Rupture Following Radiofrequency Ablation for Benign Thyroid Nodules

Important parameters should be paid attention in PTMC radiofrequency ablation

Modern Surgical Techniques of Thyroidectomy and Advances in the Prevention and Treatment of Perioperative Complications

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