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

Ou, Dawei; Chen, Chen; Tian, Jie; Xu, Dong

doi:10.3389/fonc.2022.859396

Cited by 15 publications

(13 citation statements)

References 96 publications

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“…Although TA has some limitations in the treatment of PTMC, experts believe that TA can not only cure PTMC, but also relieve the psychological burden of patients with cancer 63 . There was no significant difference in the incidence of local recurrence, LNM, distant metastases, and retreatment between TA and surgery in the treatment of PTMC, 64 and the efficacy of TA in PTMC treatment was confirmed in a 10‐year follow‐up 41 . Few reports of hypothyroidism after thermal ablation alone have been reported, and many studies have included hypothyroidism as a minor complication.…”

Section: Resultsmentioning

confidence: 97%

Ultrasound‐guided thermal ablation for papillary thyroid microcarcinoma: A systematic review

Zhang

2022

Clinical Endocrinology

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Objective Thyroidectomy is the first‐line treatment for papillary thyroid microcarcinoma (PTMC), but often involves aggressive overtreatment. Thermal ablation (TA) has been gradually used for the treatment of recurrent PTMC. However, it is not recommended for the treatment of primary PTMC according to the Korean and Italian guidelines. Therefore, this systematic review aimed to analyse the indications, efficacy, and safety of TA in the treatment of PTMC. Design Systematic review. Patients and Measurements A search strategy was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. A total of 27 articles were included in this study until January 2022. Results According to current guidelines and studies, we divided the indications of TA for PTMC into six primary and three secondary indications. Laser ablation (LA) has the advantages of a small needle, accurate output energy and precision ablation, and it is safe to important organs around the lesion. The patients recover quickly after radiofrequency ablation (RFA), with no major complications, recurrence, or lymph node metastasis. The volume reduction rate after RFA was the highest, followed by microwave ablation and LA, and the improvement in patient quality of life after TA was significantly better than after thyroidectomy. Conclusions TA is an effective alternative method for surgery in the treatment of low‐risk PTMC and has the advantages of being minimally invasive, economical, having less bleeding and having a high postoperative quality of life.

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Section: Resultsmentioning

confidence: 97%

Ultrasound‐guided thermal ablation for papillary thyroid microcarcinoma: A systematic review

Zhang

2022

Clinical Endocrinology

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“…A recent review article by Ou et al examined 40 published studies that evaluated the safety and efficacy of percutaneous thermal ablation in low-risk papillary thyroid cancer (Ou et al 2022). The articles reviewed by Ou included data on percutaneous thermal ablation of 5268 low-risk papillary thyroid cancer nodules in 5074 patients (Table 1).…”

Section: Overview Of Published Case Series Examining Thermal Ablation...mentioning

confidence: 99%

“…In Ou et al's review of 40 retrospective case series (Ou et al 2022), after a mean follow-up period of 3.3 years, recurrence with the ablation zone was identified in 1.2% (65/5268 ablated nodules), while newly identified cervical lymph node metastasis was documented in 0.6% (32/5074 patients) (Table 1). Additionally, in a metaanalysis restricted to patients followed for at least 5 years after thermal ablation, the recurrence within the thyroid gland was detected in only 5 of the 207 patients (2.4%) with none of the recurrences developing in the previous ablation zone (Cho et al 2021).…”

Section: :3mentioning

confidence: 99%

Percutaneous ablation of low-risk papillary thyroid cancer

Tuttle

Ridouani

2023

Endocrine-Related Cancer

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Minimalistic management options such as active surveillance and thyroid lobectomy are increasingly being accepted as reasonable management options for properly selected patient with low-risk papillary thyroid cancer. Leveraging technologies developed for the treatment of benign thyroid nodules, ultrasound guided percutaneous thermal ablation is now being evaluated as a potential additional minimalistic management option for small, intrathyroidal, low-risk papillary thyroid cancer. Published retrospective data on more than 5,000 low risk papillary thyroid cancer patients treated with thermal ablation indicate that with appropriate training and proper patient selection these technologies can be safely and effectively applied to papillary microcarcinomas. When compared to immediate surgery, thermal ablation appears to have lower complication rates with similar short-term rates of recurrence. Proper patient selection is facilitated by use of a clinical framework which integrates imaging characteristics, patient characteristics, and medical team characteristics to classify a patient as ideal, appropriate, or inappropriate for minimalistic management options (active surveillance, thyroid lobectomy, or thermal ablation). While retrospective in nature and lacking randomized prospective clinical trial data, currently available data does support the proposition that thermal ablation technologies reliably destroy papillary thyroid microcarcinoma lesions and are associated with clinically acceptable oncologic outcomes when done by experienced teams in properly selected patients.

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“…Indeed, most patients with PTC did not show significant changes in dynamic observation. However, some patients withdrew from dynamic observation due to concerns or local progression and went for surgery instead ( 13 ). Thermal ablation therapy is the third option in addition to surgery and dynamic observation because it can effectively treat PTC without the huge trauma like surgery, nor will it cause obvious damage to thyroid function.…”

Section: Introductionmentioning

confidence: 99%

“…Thermal ablation therapy is the third option in addition to surgery and dynamic observation because it can effectively treat PTC without the huge trauma like surgery, nor will it cause obvious damage to thyroid function. Therefore, patients who are unwilling to perform dynamic observation in the past can use thermal ablation therapy, which can not only relieve the patient’s physical and psychological discomfort, but also avoid the damage caused by the operation, making thermal ablation therapy possible solution to solve the overtreatment of PTMC ( 13 ). These thermal ablation techniques all have unique advantages and have been shown to achieve favorable clinical results, with a low incidence of complications ( 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Over than three-year follow-up results of thermal ablation for papillary thyroid carcinoma: A systematic review and meta-analysis

2022

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BackgroundThis study is a meta-analysis based on evidence-based medicine to explore the long-term (≥3 years) efficacy of thermal ablation in the treatment of papillary thyroid carcinoma (PTC).MethodsWe searched the PubMed, Embase, and Cochrane Library databases for studies published during the time between the establishment of the databases through June 2022. We included 13 non-randomized-controlled trials (non-RCTs) that reported the application of ultrasound-guided thermal ablation in PTC. We excluded studies that were repeated publications, research without full text, contained incomplete information, lacked data extraction, involved animal experiments, reviews, and systematic reviews. STATA 15.1 software was used to analyze the data.ResultsTumor volume after thermal ablation at 3-year follow-up was significantly lower than pre-ablation (standardized mean difference [SMD] = -1.06, 95% CI: -1.32~-0.80). The pooled results indicated that the maximum diameter after thermal ablation at 3-year follow-up was significantly lower than pre-ablation (SMD = -1.93, 95% CI: -12.13~-1.73). The pooled results indicated that volume reduction rate (VRR) after thermal ablation at 3-year follow-up was 98.91% (95% CI: 97.98–99.83%), and complete disappearance rate (CDR) after thermal ablation at 3-year follow-up was 83% (95% CI: 67–94%). In addition, the incidence of newly discovered mPTC and lymph node metastases after thermal ablation was 0.3% (95% CI: 0.0–1.0%) and 0.0% (95% CI: 0.0–0.0%), respectively.ConclusionOverall, the long-term (≥3 years) efficacy of ultrasound-guided thermal ablation in the treatment of PTC was significant, with favorable disease progression. Ultrasound-guided thermal ablation can be considered an alternative approach for patients with PTC who refuse surgery or are unable to undergo surgery.

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

Cited by 15 publications

References 96 publications

Ultrasound‐guided thermal ablation for papillary thyroid microcarcinoma: A systematic review

Ultrasound‐guided thermal ablation for papillary thyroid microcarcinoma: A systematic review

Percutaneous ablation of low-risk papillary thyroid cancer

Over than three-year follow-up results of thermal ablation for papillary thyroid carcinoma: A systematic review and meta-analysis

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