Comparison of radiofrequency ablation and operation for overmuch residual thyroid removal before 131I treatment in differentiated thyroid cancer

doi:10.3877/cma.j.issn.1672-6448.2018.04.009

Abstract

Abstract:

Objectives

The aim of this study is to compare efficacy and safety of radiofrequency ablation versus operation for overmuch residual thyroid removal before ¹³¹I treatment in differentiated thyroid cancer.

Methods

Clinical data from 52 newly diagnosed differentiated thyroid cancer patients who treated with operation at Zhejiang Cancer Hospital from January 2014 to December 2016 were retrospectively reviewed. The serum TSH was less than 30 IU/ml, and ^99mTc thyroid imaging and ultrasound examination showed obviously residual thyroid tissue after 3 weeks of low iodine diet and discontinuation of euthyrox. Of these patients, 28 cases received radiofrequency, while 24 cases treated with operation. The operation time, the waiting time of ¹³¹I treatment and the efficacy of residual thyroid tissue clearance were compared between two groups. At the same time, the complications of the two groups were observed.

Results

The mean values of operation time between two groups were (22.14±7.12) min and (55.45±13.56) min, respectively, and there was a statistically significant difference (t=11.822, P<0.05). The mean waiting time of ¹³¹I treatment in patients received radiofrequency was (9.40±4.14) days, while the mean waiting time in operation group was (13.53±4.55) days, and the differences were statistically significant (t=9.144, P<0.05). In RFA group, hoarseness, temporary parathyroid injury and permanent parathyroid injury were observed in 2 cases, 0 case and 1 case, respectively. While there were 2 cases, 3 cases and 0 case in the operative group. There were no significant differences between the two groups (all P>0.05). 85.7% (24/28) of patients in RFA group and 91.7% (22/24) in operation group showed favorable efficacy of residual thyroid removal, and there were no significant differences between the two groups (P>0.05).

Conclusion

Compared with operation, postsurgical residual thyroid tissue removal in differentiated thyroid cancer by ultrasound guided radiofrequency ablation by ultrasound guided is safe and effective, and provides a new minimally invasive treatment for patients who are reluctant to undergo surgery.

Key words: Thyroid neoplasms, Ablation techniques, Ultrasonography

Kaiyuan Shi, Dong Xu, Chuanming Zheng, Bin Long, Xiangdong You. Comparison of radiofrequency ablation and operation for overmuch residual thyroid removal before ¹³¹I treatment in differentiated thyroid cancer[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(04): 281-286.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.04.009

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I04/281

Figures/Tables 4

References 16

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临床特征		射频消融组（28例）	手术切除组（24例）	χ²值	P值
年龄		?	?	0.032	0.857
?	<30岁	10	8	?	?
?	≥30岁	18	16	?	?
性别		?	?	0.126	0.722
?	男性	7	5	?	?
?	女性	21	19	?	?
T分期		?	?	0.037	0.982
?	T2	4	3	?	?
?	T3	15	13	?	?
?	T4	9	8	?	?
残留腺体部位		?	?	0.955	0.328
?	单侧	24	18	?	?
?	双侧	4	6	?	?
残留腺体体积		?	?	0.119	0.730
?	<3 cm³	13	10	?	?
?	≥3 cm³	15	14	?	?

临床特征		射频消融组（28例）	手术切除组（24例）	χ²值	P值
年龄		?	?	0.032	0.857
?	<30岁	10	8	?	?
?	≥30岁	18	16	?	?
性别		?	?	0.126	0.722
?	男性	7	5	?	?
?	女性	21	19	?	?
T分期		?	?	0.037	0.982
?	T2	4	3	?	?
?	T3	15	13	?	?
?	T4	9	8	?	?
残留腺体部位		?	?	0.955	0.328
?	单侧	24	18	?	?
?	双侧	4	6	?	?
残留腺体体积		?	?	0.119	0.730
?	<3 cm³	13	10	?	?
?	≥3 cm³	15	14	?	?

组别	例数	声音嘶哑	暂时甲旁腺损伤	永久甲旁腺损伤
射频消融组	28	2	0	1
手术切除组	24	2	3	0
χ²值	?	0.026	3.714	0.874
P值	?	0.872	0.054	0.350

组别	例数	声音嘶哑	暂时甲旁腺损伤	永久甲旁腺损伤
射频消融组	28	2	0	1
手术切除组	24	2	3	0
χ²值	?	0.026	3.714	0.874
P值	?	0.872	0.054	0.350

组别	例数	平均用时（min）	平均等待时间（d）	术前甲状腺摄锝率（%）	术后甲状腺摄锝率（%）
射频消融组	28	22.14±7.12	9.40±4.14	0.70±0.16	0.31±0.12
手术切除组	24	55.45±13.56	13.53±4.55	0.78±0.16	0.28±0.10
t值	?	11.822	9.144	0.164	0.184
P值	?	0.001	0.003	0.702	0.504

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