Ultrasonography-guided Radiofrequency Ablation for Solitary T1aN0M0 and T1bN0M0 Papillary Thyroid Carcinoma: A Retrospective Comparative Study

2021 ◽  
Author(s):  
Jing Xiao ◽  
Yan Zhang ◽  
Lin Yan ◽  
Mingbo Zhang ◽  
Xinyang Li ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumour Progression ◽  
Survival Rates ◽  
Recurrent Laryngeal Nerve Injury ◽  
Papillary Thyroid ◽  
Free Survival ◽  
Institutional Review ◽  
Retrospective Comparative Study

Objective Ultrasonography-guided radiofrequency ablation (RFA) is used to treat small low-risk papillary thyroid carcinoma (PTC), and has achieved favorable results. However, few studies have compared the outcomes of T1aN0M0 and T1bN0M0 PTC treated with ultrasonography-guided RFA. The objective of this study was to compare the outcomes of patients receiving RFA for solitary T1aN0M0 and T1bN0M0 PTC retrospectively. Methods Patients treated with RFA for solitary T1aN0M0 or T1bN0M0 PTC between April 2014 and December 2019 were retrospectively reviewed. All patients were ineligible for or refused surgery. Our institutional review board approved this study. A total of 262 patients were included after adjustment for propensity score matching between the T1a and T1b groups. Local tumour progression (LTP), LTP-free survival, post-treatment complications, change in tumor volume, and RFA-related parameters were compared between the two groups. Results The LTP rate was 3.82% in both groups, and the LTP and LTP-free survival rates did not significantly differ between the two groups. One patient in group T1b developed transient recurrent laryngeal nerve injury. Significant tumor shrinkage was observed during the follow-up. The rate of tumour disappearance rate was higher in group T1a than in group T1b (81.7% vs. 52.7%, P<0.001). During RFA, the output power and total energy were higher and the duration was significantly shorter in group T1b than in group T1a (P<0.001). Conclusions The outcomes of RFA for the treatment of T1aN0M0 and T1bN0M0 PTC were similar. Therefore, RFA may be an alternative to surgery for the treatment of T1bN0M0 and T1aN0M0 PTCs.

scholarly journals Should Contralateral Nodules Be an Indication of Total or Completion Thyroidectomy for Patients With Unilateral Papillary Thyroid Carcinoma?

2021 ◽  
Vol 12 ◽  
Author(s):  
Tengfei Ma ◽  
Haiyang Wang ◽  
Jifeng Liu ◽  
Jian Zou ◽  
Shixi Liu
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Survival Rates ◽  
Recurrence Free Survival ◽  
Completion Thyroidectomy ◽  
Papillary Thyroid ◽  
Free Survival ◽  
Benign Nodules ◽  
Disease Specific

ObjectiveTo determine whether papillary thyroid carcinoma (PTC) patients with benign or nonsuspicious nodules in the contralateral lobe have a higher rate of recurrence or worse survival after lobectomy compared to those without nodules in the contralateral lobe.MethodsAdult patients who underwent lobectomy and were diagnosed with unilateral PTC (2013-2015), were identified from an institutional database. Patients who previously had cytologically benign nodules or nonsuspicious nodules in the contralateral lobe comprised the contralateral nodule (CN) group. Patients who did not have nodules in the contralateral lobe comprised the unilateral nodule (UN) group.Results370 patients were included: 242 in the UN group and 128 in the CN group. After a median follow-up of 62 months (range, 16–85 months), recurrence was confirmed in 4.1% patients in the UN group and 5.5% patients in the CN group (p = 0.559). Clinical contralateral lobe PTC was detected in 2.9% (7/242) of patients from the UN group and 3.9% (5/128) of patients from the CN group (p = 0.601). The 5-year contralateral lobe recurrence-free survival (RFS) rates were 96.8% in the UN group and 97.4% in the CN group (p = 0.396). The 5-year loco-regional RFS rates were 98.4% in the UN group and 97.8% in the CN group (p = 0.690). The 5-year disease-specific survival rates were both 100%.ConclusionPTC patients with benign or nonsuspicious CNs have similar recurrence and survival rates after lobectomy compared to those without CNs. CNs alone should not be an indication for total or completion thyroidectomy.

scholarly journals Clinical value of matrix metalloproteinase-2 and -9 in ultrasound-guided radiofrequency ablation treatment for papillary thyroid carcinoma

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052091758
Author(s):  
Qunyan Pan ◽  
Tao Yuan ◽  
Qian Ding
Keyword(s):  
Radiofrequency Ablation ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Matrix Metalloproteinase ◽  
Enzyme Linked Immunosorbent Assay ◽  
Papillary Thyroid ◽  
Affecting Factors ◽  
Ultrasound Guided ◽  
Lesion Diameter ◽  
Preoperative Serum

Objective This study aimed to investigate serum matrix metalloproteinase (MMP)-2 and MMP-9 levels in patients with papillary thyroid carcinoma (PTC). Methods Forty-one patients with PTC undergoing ultrasound-guided radiofrequency ablation (RFA) and 56 controls were included. Serum MMP-2 and MMP-9 levels were determined by enzyme-linked immunosorbent assay before and after surgery. Potential affecting factors were evaluated by logistic regression analysis. Results Serum MMP-2 and MMP-9 levels were significantly higher in PTC patients compared with controls, and decreased significantly after surgery. According to receiver operating characteristic curve analysis, diagnostic values for preoperative serum MMP-2 and MMP-9 levels were 82.4% and 86.6%. There was no contrast-agent perfusion in the ablation zone in 88.5% of lesions, and enhancement within or at the lesion edge in 11.4%. The volume reduction at 3 months’ follow-up was >40%. Age, microcalcification, irregular shape, and lesion diameter and number were influencing factors for PTC. Age, and lesion diameter and number were independent risk factors, while calcification and morphology were protective factors. Conclusion Serum MMP-2 and MMP-9 levels have important clinical values for the diagnosis and treatment of PTC by RFA. Preoperative serum MMP-2 and MMP-9 levels, combined with other affecting factors, contribute to disease prognosis.

scholarly journals Review of survival rates 20-years after conservative surgery for papillary thyroid carcinoma

2015 ◽  
Vol 81 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Abrão Rapoport ◽  
Otávio Alberto Curioni ◽  
Ali Amar ◽  
Rogério Aparecido Dedivitis
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Survival Rates ◽  
Conservative Surgery ◽  
Papillary Thyroid

scholarly journals Radiofrequency Ablation for Cervical Metastatic Lymph Nodes in Children and Adolescents With Papillary Thyroid Carcinoma: A Preliminary Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Lin Yan ◽  
Ying Zhang ◽  
Bo Jiang ◽  
Yukun Luo
Keyword(s):  
Radiofrequency Ablation ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Children And Adolescents ◽  
Papillary Thyroid ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
The Mean

ObjectiveTo evaluate the safety and efficacy of radiofrequency ablation (RFA) for metastatic lymph nodes (LNs) in children and adolescents with papillary Thyroid Carcinoma (PTC).Materials and MethodsFrom December 2014 to March 2018, 10 metastatic LNs(mean volume 0.30 ± 0.38 ml, range 0.06-1.23ml) in 5 children and adolescents (3 females, 2 males; mean age 15.60 ± 2.97 years, range 12-19 years) with PTC treated by RFA were evaluated in this study. The mean number of surgical procedures performed before RFA was 1.2 (range 1-2) and the mean number of treated metastatic LNs per patient was 2 (rang 1-3). RFA was performed with an 18–gauge bipolar RF applicator under local anesthesia. Follow-up consisted of US and serum thyroglobulin (Tg) level at 1, 3, 6, 12 months and every 12 months thereafter.ResultsAll the patients were well tolerant to RFA procedure and no procedure-related complications occurred. During a mean follow-up time of 52.00 ± 21.44 months, the initial volume of LNs was 0.30 ± 0.38 ml, which significantly decreased to 0.01 ± 0.03 ml (P = 0.005) with a mean VRR of 99.28 ± 2.27%. A total of 9 metastatic LNs (90.00%) completely disappeared. After RFA, 2 patients developed newly metastases. One patient had additional RFA. The other one with multiple LN metastases underwent total thyroidectomy with central neck dissection.ConclusionAs a less invasive and effective technique, RFA may provide another alternative to the existing therapeutic modalities for cervical metastatic LNs in children and adolescents with PTC.

scholarly journals Ultrasound-Guided Radiofrequency Ablation Versus Surgical Resection for the Treatment of T1bN0M0 Papillary Thyroid Carcinoma in Different Age Groups

2021 ◽  
Vol 12 ◽  
Author(s):  
Hongying He ◽  
Rilige Wu ◽  
Jiahang Zhao ◽  
Qing Song ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Tumor Progression ◽  
Surgical Resection ◽  
Age Groups ◽  
Papillary Thyroid ◽  
Voice Change ◽  
Aged Patients ◽  
Treatment Groups

PurposeWe aimed to compare the efficacy and safety of radiofrequency ablation (RFA) to that of surgical resection (SR) in patients with T1bN0M0 papillary thyroid carcinoma (PTC) in different age groups.MethodsTotally, 204 patients with an isolated, solitary, intrathyroidal T1bN0M0 PTC, who underwent either RFA (n=94) or SR (n=110) between April 2014 and December 2019, were retrospectively enrolled and were divided into two subgroups according to age (&lt;45 years, ≧45 years). Patients with pathologically aggressive or advanced lesions were excluded from the study. Tumor progression and procedural complications were the primary and secondary endpoints, respectively. Tumor recurrence in situ, newly discovered tumors, lymph node involvement, or distant metastases indicated tumor progression. Complications included pain, fever, voice change, choking, numbness in the limbs, and cardiac events. Incidence rates of all endpoint events were compared between different age subgroups.ResultsThere were no significant differences in age, sex, and tumor size between the treatment groups. While the RFA group incurred less cost and experienced significantly shorter operative duration than the SR group, no significant differences were observed in incidences of both tumor progression and complications. Further, subgroup analysis of patients &lt;45 years versus those ≧45 years showed no significant differences in the incidence of tumor progression and complications within or between different treatment groups. Older patients in the SR group incurred higher hospital costs than younger counterparts, but this difference was not observed in the RFA group.ConclusionsOur results indicated that RFA had a similar prognosis as that of SR but was associated with lower overall cost in both young (&lt;45 years) and middle-aged patients (≧45 years) with T1bN0M0 PTC. Therefore, RFA may be an effective and safe alternative to surgery for the treatment of patients with T1bN0M0 PTC.

scholarly journals Impact of Prophylactic Bilateral Central Lymph Nodes Dissection in Patients with Papillary Thyroid Carcinoma; Short Term Outcome

2020 ◽  
pp. 18-25
Author(s):  
Mohammed Farid Elhelbawy ◽  
Ahmed Elgendy ◽  
Ahmed Attia Darwish ◽  
Abd El-Wahhab Hemedah Gad
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Laryngeal Nerve Injury ◽  
Central Lymph

Background: Papillary thyroid carcinoma is the most common thyroid carcinoma. There is a debate on prophylactic removal of central lymph nodes. Some authors advise it to avoid recurrence while other investigators condemn it due to its higher risk of recurrent laryngeal nerve injury and/or hypoparathyroidism. Aim of the Work: The aim of this study was to evaluate the safety and morbidity of central lymph nodes dissection during total thyroidectomy in the management of patients with papillary thyroid carcinoma. Patients and Methods: Twelve patients were confirmed by histopathological evaluation to have papillary thyroid examination. Total thyroidectomy was done through transverse neck incision followed by removal of bilateral central group of lymph nodes. Patients were examined postoperatively for recurrent laryngeal nerve injury or hypoparathyroidism. Follow up was done 6 months later with neck ultrasonography, thyroglobulin and antithyroglobulin antibodies. Results: Thirty four percent of the studied cases proved to have lymph nodes metastasis. temporary hypocalcemia occurred in only one patient in this study and was temporary. Recurrent laryngeal nerve affection happened in 17% of the studied cases and was reversible by medical treatment. No evidence of recurrence happened in the first 6 months after operation. Conclusion: The risk of postoperative recurrent laryngeal nerve injury or hypoparathyroidism is minimal after prophylactic CLND. Postoperative hypocalcemia and recurrent laryngeal nerve injury are usually reversible.

scholarly journals CD73 Overexpression Promotes Progression and Recurrence of Papillary Thyroid Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3042 ◽  
Author(s):  
Young Mun Jeong ◽  
Haejin Cho ◽  
Tae-Min Kim ◽  
Yourha Kim ◽  
Sora Jeon ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
High Expression ◽  
Migration And Invasion ◽  
Recurrence Free Survival ◽  
Papillary Thyroid ◽  
Tumor Immune Escape ◽  
Free Survival ◽  
Mesenchymal Transition ◽  
Cd73 Expression

CD73 is involved in tumor immune escape and promotes the growth and progression of cancer cells. The functional role of CD73 expression in papillary thyroid carcinoma (PTC) has not yet been established. In 511 patients with PTC, immunohistochemistry for CD73 on tissue microarrays showed that the high expression of CD73 was associated with an aggressive histologic variant (p = 0.002), extrathyroidal extension (p < 0.001), lymph node metastasis (p < 0.001), and BRAFV600E mutation (p = 0.015). Survival analysis results showed that patients with high CD73 expression had worse recurrence-free survival (p = 0.023). CD73 inhibitors induced G1 cell cycle arrest and apoptosis, inhibited the migration and invasion of PTC cells, and suppressed tumor growth in PTC xenograft nude mice. High expression of CD73 (NT5E) mRNA was associated with unfavorable clinicopathologic characteristics, the abundance of Tregs and dendritic cells, depletion of natural killer (NK) cells, and high expression of immune checkpoint genes and epithelial-to-mesenchymal transition-related genes in The Cancer Genome Atlas (TCGA) dataset. Taken together, CD73 expression promotes tumor progression and predicts low recurrence-free survival. Targeting the CD73–adenosine axis in the tumor microenvironment offers an attractive pathway for therapeutic strategies aimed at advanced PTC.

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