Ultrasound-Guided Radiofrequency Ablation Versus Surgery for Low-Risk Papillary Thyroid Microcarcinoma: Results of Over 5 Years' Follow-Up

Zhang, Mingbo; Tufano, Ralph P.; Russell, Jonathon O.; Zhang, Ying; Zhang, Yan; Qiao, Zhi; Luo, Yukun

doi:10.1089/thy.2019.0147

Cited by 146 publications

(165 citation statements)

References 49 publications

Supporting

Mentioning

164

Contrasting

Unclassified

Order By: Relevance

“…Despite the growing evidence, even in the absence of randomized controlled trials offering evidence of efficacy of TA for small and low-risk PTMCs [49,50], the use of TA is currently considered only by a small minority of the responders, and is deemed as a less appropriate management alternative than watchful waiting without any intervention.…”

Section: Thyroid Cancer and Lymph Node Metastasesmentioning

confidence: 99%

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

Hegedűs¹,

Frasoldati²,

Negro³

et al. 2020

Eur Thyroid J

View full text Add to dashboard Cite

Objective: Image-guided interventional ultrasound (US) techniques represent diagnostic and therapeutic tools for non-surgical management of thyroid nodular disease. We sought to investigate the attitude of European Thyroid Association (ETA) members towards the use of minimally invasive techniques (MIT) in diagnosis/therapy of symptomatic nodular goitre. Methods: ETA members were invited to participate in an online survey investigating the use of MIT in benign and malignant thyroid nodular disease. Of 865 invited members, 221 (25.5%) completed the survey. The respondents were from 40 countries; 139 (74.7%) were from European countries. Results: Respondents personally performed thyroid US (91.6%), Fine needle aspiration (FNA; 75.3%), ethanol ablation (EA; 22.1%), core needle biopsy (CNB; 11%) and thermal treatments (4.8%). When skills and/or technology were unavailable, only 13.4% referred patients "often" or "always" to other centres with specific expertise in this field. Surgery was the preferred first option in patients with recurrent cysts, 4.0 cm benign nodules, local (radioiodine-avid or non-avid) lymph node metastases, or papillary cancers < 1.0 cm. For autonomously functioning nodules radioactive iodine treatment was the preferred choice, followed by surgery. Thermal ablation (TA) was the preferred option only for a 4 cm benign nodule in old patients with comorbidities. Conclusions: US, US-guided FNA and surgery were available to nearly all respondents, while MIT was not. CNB and EA were employed only by about 1/3 of the respondents and TA procedures were available and personally performed only by a minority. For most thyroid lesions, surgery was the preferred option versus thermal therapies. The ETA needs to develop guidelines and establish teaching to overcome geographic inequality and promote the use of MIT as a valid therapy option in appropriate cases.

show abstract

Section: Thyroid Cancer and Lymph Node Metastasesmentioning

confidence: 99%

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

Hegedűs¹,

Frasoldati²,

Negro³

et al. 2020

Eur Thyroid J

View full text Add to dashboard Cite

show abstract

“…Regarding the demographic characteristics of the patients in the seven studies, the mean age ranged between 31 years and 60 years. The mean initial tumor diameter ranged 1 and 10 mm in 4 studies [21][22][23][24].The remaining three studies [25][26][27] didn't list in detail, but had mentioned a maximum diameter of less than 10 mm. All studies reported complication rate after the TA or RS [21][22][23][24][25][26][27].…”

Section: Literature Searchmentioning

confidence: 99%

Comparison of thermal ablation and routine surgery for the treatment of papillary thyroid microcarcinoma: a systematic review and Meta-analysis

Shen

Xue

Xie

et al. 2020

International Journal of Hyperthermia

View full text Add to dashboard Cite

Background: Thermal ablation (TA), as an alternative to surgery, has shown some benefits in the treatment of papillary thyroid microcarcinoma (PTMC) patients, especially for those who are at high risk for surgery or refuse surgery. We performed a systematic review and meta-analysis to evaluate the efficiency, safety, and economy of TA, compared with those of routine surgery (RS), for the treatment of PTMC. Methods: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases were retrieved from inception to 10 January 2020 to identify relevant original studies on comparison of TA and RS for treatment of PTMC. The recurrence rate, recurrence-free survival (RFS), complication rate, operation time, postoperative length of stay, and cost during the perioperative period were extracted as main indices. The pooled standardized mean difference (SMD) or odds ratio (OR) with 95% confidence intervals (CI) were calculated and analyzed. Chi-square test and I 2 statistic were applied to determine the heterogeneity among studies. The sensitivity analysis was applied to explore the origin of heterogeneity, and the publication bias was evaluated by Egger's test. Results: Seven retrospective studies with a total of 867 patients met the eligibility criteria and were included in the final meta-analysis. Our study demonstrated that TA showed significant reduction in complication with a pooled OR 0.24 (95% CI 0.13 to 0.43), postoperative length of stay with a pooled SMD À3.14 (95% CI À4.77 to À1.51) and cost during the perioperative period with a pooled SMD of À1.69 (95% CI À3.18 to À0.20). It also demonstrated that both TA and RS had similar pooled proportion of recurrence of OR 0.93 (95% CI 0.38 to 2.30) and recurrence-free survive (RFS). The sensitivity analysis showed that each included study had no significant effect on the results and the results were stable and reliable. The Egger's test demonstrated publication bias was acceptable. Conclusions: TA may not be oncologically inferior to RS, and it is a relatively safe and economical alternative for the treatment of PTMC.

show abstract

“…Ultrasound-guided radiofrequency ablation (RFA) is an important therapeutic measure for hepatocellular carcinoma (HCC) [14,15] and has yielded good results not only in the treatment of benign thyroid nodule [16,17] but also in the treatment of low-risk PTMC, which have been confirmed by several studies. In addition, our 5-year followup results showed that PTMC patients undergoing RFA have a good lesion reduction rate, few postoperative complications, quite a few recurrence/metastasis rates [18].…”

Section: Introductionmentioning

confidence: 60%

“…This issue is likely responsible for the increased complaints of psychological issues and anxiety [35], which are associated with the HRQoL after treatment. As a new therapeutic measure for PTMC, the efficacy and safety of ultrasound-guided RFA have been widely proven [18,36], but there are few studies on the quality of life of PTMC patients after RFA. In order to further improve the quality of PTMC patients after treatment, this study found through multivariate linear regression analysis that female gender, the symptoms of neuromuscular and throat/mouth, inattention, psychological anxiety and the fear of their own physical health were the main risk factors affecting the quality of life patients.…”

Section: Discussionmentioning

confidence: 99%

“…HRQoL is defined as the subjective perception that an individual's important activities are affected by the current status of health, which reflects the individual's satisfaction and happiness with life [21]. Our previous studies have demonstrated that the HRQoL of PTMC patients undergoing RFA is better than that of patients undergoing surgery [18,22]. Nevertheless, HRQoL of PTMC survivors after RFA is affected by a variety of factors, such as disease-specific symptoms, fear of disease progression, social interaction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with health-related quality of life in papillary thyroid microcarcinoma patients undergoing radiofrequency ablation: a cross-sectional prevalence study

Lan

Jin

Zhang

et al. 2020

International Journal of Hyperthermia

Self Cite

View full text Add to dashboard Cite

Purpose: To explore the association of demographic characteristics, clinical symptoms and the fear of the disease progression factors with the physical and mental summary components of the healthrelated of life (HRQoL) of the papillary thyroid microcarcinoma (PTMC) patients undergoing radiofrequency ablation (RFA). Methods: 123 PTMC survivors undergoing RFA were enrolled in this study from October 2019 to March 2020. Demographic, clinical symptoms and the fear of the disease progression data were collected. SF-36, THYCA-QoL and FoP-Q-SF were used to evaluate the HRQoL of patients, clinical symptoms and the fear of disease progression. A multivariate regression model was performed to evaluate the association between the independent variable and the HRQoL variable. Results: The average self-reported HRQoL score was 81.17 ± 15.48 for the PCS and 73.40 ± 18.03 for the MCS. The multivariate linear regression model shows that the factors related to a poorer PCS were dependent for the female patients, the symptoms of neuromuscular and the throat/mouth, the fear of disease progression; the psychological disorder, symptoms of throat/mouth, inability to concentrate were related to worse scores for the MCS. The condition that was most strongly related to a poorer HRQoL (in both PCS and MCS) was the fear of their physical health. Conclusions: The factors related to significantly worse HRQoL scores across PCS and MCS for PTMC survivors include the female gender, the symptoms of neuromuscular and the throat/mouth, the psychological disorder, inability to concentrate, and the fear of their own physical health. Identification, management, and prevention of these factors are critical to improving the HRQoL of patients.

show abstract

Ultrasound-Guided Radiofrequency Ablation Versus Surgery for Low-Risk Papillary Thyroid Microcarcinoma: Results of Over 5 Years' Follow-Up

Cited by 146 publications

References 49 publications

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

Comparison of thermal ablation and routine surgery for the treatment of papillary thyroid microcarcinoma: a systematic review and Meta-analysis

Factors associated with health-related quality of life in papillary thyroid microcarcinoma patients undergoing radiofrequency ablation: a cross-sectional prevalence study

Contact Info

Product

Resources

About