Long-term clinical outcomes of ultrasound-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma

doi:10.3877/cma.j.issn.1672-6448.2023.02.012

Abstract

Abstract:

Objective

To assess the long-term clinical outcomes of radiofrequency ablation (RFA) for low-risk unifocal papillary thyroid microcarcinoma (PTMC) in a large population.

Methods

From June 2014 to May 2017, 349 patients (273 females and 76 males; age range,18 to 73 years) with low-risk unifocal PTMC were treated by RFA at the First Medical Centre of Chinese PLA General Hospital. The mean diameter was (5.23±1.58) mm and the median volume was 65.45 (93.46) mm³. The patients were followed by ultrasound and contrast-enhanced ultrasound (CEUS) at 1, 3, 6, 12 months and every 6-12 months thereafter. The volume reduction was calculated. Recurrence and lymph node or distant metastasis were evaluated.

Results

The mean follow-up time was (45.94±10.05) months. The median initial volume decreased form 65.45 (93.46) mm³ to 0 mm³, with a median volume reduction rate of 100%. No life-threatening or delayed complications occurred. Since 18 and 12 ablated areas disappeared at 3 and 6 months, respectively, 319 ablated areas underwent post-ablation core-needle biopsy, and the results were all negative. A total of 13 patients developed local tumor recurrence and the overall incidence of local tumor progression was 3.72%. Among them, 4 patients (1.15%) developed lymph node metastasis and 9 (2.58%) had recurrent PTMC. A total of 12 patients underwent additional RFA, among which the lesions completely disappeared during the follow-up period in 10 cases, and two lesions decreased in size.

Conclusions

RFA is an effective and safe treatment for low-risk unifocal PTMC, which could become a first-line treatment for low-risk PTMC.

Key words: Radiofrequency ablation, Papillary thyroid microcarcinoma, Ultrasonography, Follow-up study

Lin Yan, Yu Lan, Fang Xie, Yukun Luo. Long-term clinical outcomes of ultrasound-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(02): 227-231.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2023.02.012

https://chaosheng.cma-cmc.com.cn/EN/Y2023/V20/I02/227

Figures/Tables 2

References 30

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时间	体积（mm³）	Z值	P值	体积缩小率（%）
消融前	65.45（93.46）	-	-	-
消融即刻	753.96（581.18）	-16.167	<0.001	-
术后1个月	293.21（287.97）	-14.979	<0.001	-348.00（526.22）
术后3个月	87.96（138.23）	-3.710	<0.001	-14.33（202.89）
术后6个月	18.85（64.40）	-7.834	<0.001	43.12（75.00）
术后12个月	0（6.28）	-13.702	<0.001	100.00（8.00）
术后18个月	0	-12.665	<0.001	100
术后24个月	0	-15.312	<0.001	100
术后36个月	0	-13.008	<0.001	100
术后48个月	0	-10.120	<0.001	100

时间	体积（mm³）	Z值	P值	体积缩小率（%）
消融前	65.45（93.46）	-	-	-
消融即刻	753.96（581.18）	-16.167	<0.001	-
术后1个月	293.21（287.97）	-14.979	<0.001	-348.00（526.22）
术后3个月	87.96（138.23）	-3.710	<0.001	-14.33（202.89）
术后6个月	18.85（64.40）	-7.834	<0.001	43.12（75.00）
术后12个月	0（6.28）	-13.702	<0.001	100.00（8.00）
术后18个月	0	-12.665	<0.001	100
术后24个月	0	-15.312	<0.001	100
术后36个月	0	-13.008	<0.001	100
术后48个月	0	-10.120	<0.001	100

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