Radiofrequency ablation versus total thyroidectomy in patients with papillary thyroid microcarcinoma located in the isthmus: a retrospective cohort study

Song, Qing; Gao, Hanjing; Ren, Ling; Tian, Xiaoqi; Lan, Yu; Yan, Lin; Luo, Yukun

doi:10.1080/02656736.2021.1916625

Cited by 19 publications

(21 citation statements)

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“…The main treatment for PTMC remains surgical resection; however, thermal ablation has been shown to benefit patients with PTMC as an alternative to surgery. Several studies have been conducted to compare the two treatment modalities (48)(49)(50)(51)(52)(53), thermal ablation and surgery, and the results show that thermal ablation has comparable efficacy to surgery in the treatment of PTMC. A meta-analysis including 339 thermal ablation and 314 surgical patients (54) showed no statistically significant differences in the rates of local tumor recurrence, lymph node metastasis, distant metastasis, and salvage surgery between surgery and ablation.…”

Section: A Comparative Study Of Thermal Ablation Versus Surgical Proc...mentioning

confidence: 99%

“…The main complications of thermal ablation of thyroid cancer are pain, voice changes, bleeding, and changes in thyroid function. Patients have widespread pain after ablation, with a 100% incidence of postoperative pain demonstrated by Zhou (43), Song (52), and Wang (60). Although criteria for assessing postoperative pain are difficult to establish, the duration of pain was short in all studies, and pain relief occurred within 1 week postoperatively.…”

Section: Complicationsmentioning

confidence: 99%

“…The study demonstrated the effectiveness of the thermal ablation technique in the treatment of isthmic nodules. Next, the same group compared thermal ablation with surgery in the treatment of thyroid isthmus nodules (52). There was no metastasis or recurrence except for one patient in the RFA group who recurred.…”

Section: Ptc Located In the Isthmus Of The Thyroid Glandmentioning

confidence: 99%

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Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma

Chen

Tian

et al. 2022

Front. Oncol.

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BackgroundMinimally invasive treatment of thyroid tumors has become increasingly common, but has mainly focused on benign thyroid tumors, whereas thermal ablation of thyroid cancer remains controversial. Clinical studies analyzing the efficacy of thermal ablation of papillary thyroid carcinoma (PTC) have been conducted in several countries to verify its safety. Here, we screened and reviewed recent studies on the efficacy and safety of thermal ablation of PTC as well as psychological assessment, patient prognosis, recurrence, and factors affecting ablation.SummaryThe most significant controversy surrounding ablative treatment of PTC centers on its effectiveness and safety, and >40 studies have been conducted to address this issue. The studies include papillary thyroid microcarcinoma (PTMC) and non-PTMC, single PTC and multiple PTC, and controlled studies of ablative therapy and surgical treatment. In general, ablation techniques can be carefully performed and promoted under certain conditions and with active follow-up of postoperative patients. Ablation is a promising alternative treatment especially in patients who are inoperable.ConclusionsClinical studies on PTC ablation have provided new perspectives on local treatment. However, because PTC grows very slowly, it is an indolent tumor; therefore, studies with larger sample sizes and extended post-procedure follow-ups are necessary to confirm the investigators’ hypotheses.

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Section: A Comparative Study Of Thermal Ablation Versus Surgical Proc...mentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Ptc Located In the Isthmus Of The Thyroid Glandmentioning

confidence: 99%

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Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma

Chen

Tian

et al. 2022

Front. Oncol.

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“…In uncontrolled experimental studies, 27 pieces of literature were obtained after reading the titles and abstracts of the remaining literature. en, 12 pieces of literature [14][15][16][17][18][19][20][21][22][23][24][25] with 1,926 patients were finally included after excluding the literature with missing outcome measures (n � 5), incomplete data reporting (n � 3), and low-quality literature (n � 7) after reading the full text (Figure 1).…”

Section: Literature Resultsmentioning

confidence: 99%

“…(3) Complication Rate. Twelve pieces of literature [14][15][16][17][18][19][20][21][22][23][24][25] reported the incidence rate of complications after thermal ablation for PTMC. e intervention measures included EA-RFA, LA, MWA, RFA, and surgery.…”

Section: Network Meta-analysismentioning

confidence: 99%

Efficacy and Safety of Different Thermal Ablation Modalities for Papillary Thyroid Microcarcinoma: A Network Meta‐Analysis

Chen

2022

Contrast Media & Molecular Imaging

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Background. Small thyroid-like carcinoma (PTMC) is one of the most common subtypes of thyroid cancer. The main treatment options include surgery and radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA). Thermal ablation has the advantage of being less invasive and has fewer complications than traditional surgical treatment. Objective. The objective is to explore the efficacy and safety of PTMC by different thermal ablation modalities through a network meta-analysis. Methods. From the database establishment to October 2021, a computerized search of the Chinese Knowledge Infrastructure (CKNI), VIP Chinese Science and Technology Journal Full-Text Database (VP-CSJFD), WanFang Data journal article resource (WangFang), PubMed, the Cochrane Library, and Embase were performed to include the different methods of thermal ablation for small thyroid carcinoma. A retrospective study of different methods of thermal ablation of small thyroid carcinoma was included. Results. A total of 12 retrospective studies involving 1,926 patients with PTMC were included, all of which were of high quality. This study mainly involved RFA, MWA, LA, and ethanol combined with radiofrequency ablation (EA + RFA). Network meta-analysis showed no significant difference between interventions ( p > 0.05) in terms of recurrence rate. Conclusions. Surgical resection may be the measure with the lowest recurrence rate after treatment of PTMC, LA may be the measure with the lowest incidence of complications after treatment, and RFA may be the measure with the least length of hospital stay, operation time, and postoperative lymph node metastasis rate. However, due to the limitations of network meta-analysis, this result still needs to be treated with caution, and more high-quality, large-sample clinical studies are recommended for further verification.

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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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Radiofrequency ablation versus total thyroidectomy in patients with papillary thyroid microcarcinoma located in the isthmus: a retrospective cohort study

Cited by 19 publications

References 50 publications

Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma

Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma

Efficacy and Safety of Different Thermal Ablation Modalities for Papillary Thyroid Microcarcinoma: A Network Meta‐Analysis

Assessment of Radiofrequency Ablation for Papillary Microcarcinoma of the Thyroid

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