Radiofrequency Ablation of Cervical Thyroid Cancer Metastases—Experience of Endocrinology Practices in the United States

Abstract

Context Radiofrequency ablation (RFA) is used in the United States to treat benign thyroid nodules; however, experience with treating cervical recurrence/persistence of papillary thyroid cancer (PTC) is limited. Objective To evaluate the efficacy RFA for the treatment of cervical recurrence/persistence of PTC in the United States. Methods This is a retrospective, multicenter study of 8 patients who underwent RFA of 11 cervical metastatic PTC lesions between July 2020 and December 2021. The volume reduction (VR) of the lesions, thyroglobulin (Tg) levels and complications following RFA were assessed. Energy applied per unit volume (E/V) during RFA was also determined. Results Nine out of 11 (81.8%) lesions had initial volume under 0.5 ml and showed a complete (n = 8) or near complete (n = 1) response. The two lesions with initial volume over 1.1 ml had a partial response; one of which had regrowth. There was a median VR of 100% (range: 56.3–100%) after a median follow-up period of 453 days (range: 162–570 days), with corresponding decline in Tg levels from a median of 0.7 ng/ml (range: 0–15.2 ng/ml) to a median of 0.3 ng/ml (range: 0–1.3 ng/ml). All patients with an E/V of at least 4483 J/ml or higher had a complete or near complete response. There were no complications. Conclusion RFA performed in an endocrinology practice is an efficacious treatment option for selected patients with cervical metastases of PTC, particularly those who cannot or do not want to undergo further surgery.

A 6-year single-center prospective follow-up study of the efficacy of radiofrequency ablation for thyroid nodules

“…However, the risk of adverse events such as postoperative voice changes, hypothyroidism, and hypoparathyroid function was significantly lower (6)(7)(8)(9). Currently, the indications for RFA in multiple guidelines are benign thyroid nodules, thyroid micropapillary carcinoma, recurrent lymph nodes in the neck, those who refuse thyroid surgery, or those who are ineligible for surgery due to systemic disease (5,10,11). However, due to the indolent characteristics of malignant nodules and aesthetic concerns, many studies have attempted to perform RFA for low-risk papillary thyroid carcinoma (12,13).…”