Efficacy and Safety of Thermal Ablation for Treatment of Solitary T1N0M0 Papillary Thyroid Carcinoma: Multicenter Retrospective Study

被引:87
作者
Cao, Xiao-Jing [1 ]
Wang, Shu-Rong [2 ]
Che, Ying [3 ]
Liu, Juan [4 ]
Cong, Zhi-Bin [5 ]
He, Jun-Feng [6 ]
Wang, Hong-Ling [7 ]
Liu, Geng [8 ]
Guo, Jian-Qin [9 ]
Hao, Ying [10 ]
Wang, Zhong-Hua [11 ]
Zhou, Ying [12 ]
Jian, Mei [13 ]
Shi, Li-Li [14 ]
Qi, Lu [2 ]
Zhu, Ya-Lin [3 ]
Wang, Xue [5 ]
Yan, Guo-Zhen [6 ]
Shataer, Aini [7 ]
Liu, Xiao-Fang [10 ]
Wei, Ying [1 ]
Zhao, Zhen-Long [1 ]
Peng, Li-Li [1 ]
Li, Yan [1 ]
Yu, Ming-An [1 ]
机构
[1] China Japan Friendship Hosp, Dept Intervent Ultrasound Med, 2 Yinghuayuan East St, Beijing 100029, Peoples R China
[2] Binzhou Med Univ, Yantai Affiliated Hosp, Dept Med Ultrasound, Yantai, Peoples R China
[3] Dalian Med Univ, Affiliated Hosp 1, Dept Ultrasound, Dalian, Peoples R China
[4] Beijing Beicheng Chinese Med Hosp, Dept Thyroid, Beijing, Peoples R China
[5] Changchun Univ Tradit Chinese Med, Affiliated Hosp, Dept Electrodiag, Changchun, Peoples R China
[6] Inner Mongolia Univ Sci & Technol, Baotou Med Coll, Affiliated Hosp 1, Dept Ultrasound, Baotou, Peoples R China
[7] Peoples Hosp Xinjiang Uygur Autonomous, Dept Breast & Thyroid Surg, Urumqi, Peoples R China
[8] Wuhai Peoples Hosp, Dept Ultrasound, Wuhai, Peoples R China
[9] Qinghai Prov Peoples Hosp, Dept Intervent Ultrasound, Xining, Qinghai, Peoples R China
[10] Mudanjiang Tumor Hosp, Dept Ultrasound, Mudanjiang, Peoples R China
[11] Wendeng Dist Peoples Hosp, Special Inspect Sect, Wendeng, Peoples R China
[12] Hebei Hosp Tradit Chinese Med, Dept Surg 1, Shijiazhuang, Hebei, Peoples R China
[13] Bayannur Hosp, Dept Ultrasound, Bayannur, Peoples R China
[14] Laixi Municipal Hosp, Dept Ultrasound, Laixi, Peoples R China
关键词
GUIDED RADIOFREQUENCY ABLATION; ACTIVE SURVEILLANCE; LASER-ABLATION; MICROCARCINOMA; NODULES; MANAGEMENT; MICROWAVE; CANCER;
D O I
10.1148/radiol.2021202735
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Background: Microwave ablation (MWA) and radiofrequency ablation (RFA) have recently attracted interest as minimally invasive treatment modalities for papillary thyroid carcinoma (PTC). However, the ablation outcomes of T1N0M0 PTC are not well characterized. Purpose: To evaluate the efficacy and safety of thermal ablation (MWA or RFA) of solitary T1N0M0 PTC in patients who were ineligible for (due to presence of comorbid cardiovascular disease, renal failure, other malignancy, etc) or who refused surgery. Materials and Methods: This was a retrospective multicenter study of 847 patients (660 women) who underwent thermal ablation for PTC (673 T1a, 174 T1b) between March 2015 and March 2020; of these patients, 645 underwent MWA and 202 underwent RFA. The mean age of patients was 46 years +/- 11 (standard deviation) (age range, 18-81 years); the mean follow-up time was 22 months +/- 13 (range, 6-60 months). Changes in tumor size and volume and the rates of technical success, tumor disappearance, disease progression, and complications were assessed. Results: The technical success rate was 100%. Relative to preablation measurements, the maximum diameter and volume of the ablation zone increased during the 1st month after ablation (P.001), whereas there was no difference by the 3rd month; subsequently, the tumors showed reduction in size at 6, 9, and 12 months (all P.001). Complete disappearance of tumors occurred in 68% of patients (577 of 847; 69% [466 of 673] in the T1a group vs 64% [111 of 174] in the T1b group; P.001). The postablation disease progression rate was 1.1% (nine of 847 patients; 0.9% [six of 673 patients] in the T1a group vs 1.7% [three of 174 patients] in the T1b group; P =.54). The overall complication rate was 3.4% (29 of 847 patients; 2.7% [18 of 673 patients] in the T1a group vs 6.3% [11 of 174 patients] in the T1b group; P =.02). Conclusion: This multicenter study provided evidence that thermal ablation is an effective and safe treatment option in selected -patients with solitary T1N0M0 papillary thyroid carcinoma. (C) RSNA, 2021
引用
收藏
页码:209 / 216
页数:8
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