Long-Term Efficacy of Ultrasound-Guided Percutaneous Laser Ablation for Low-Risk Papillary Thyroid Microcarcinoma: A 5-Year Follow-Up Study

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2021 Aug 2

PMID 34337037

Citations 5

Authors

Kai Peng

Ping Zhou

Wengang Liu

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the long-term efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for the treatment of low-risk papillary thyroid microcarcinoma (PTMC).

Methods: From June 2012 to May 2015, 105 patients with solitary, pathologically confirmed PTMC lesions were treated with ultrasound-guided PLA. Nodule location, nodule volume, thyroid function, and clinical symptoms were evaluated before ablation. Contrast-enhanced ultrasound (CEUS) was performed 1 h after treatment to evaluate whether the ablation was complete. Ultrasound examination was performed at 1, 3, 6, and 12 months after ablation and every 6 months thereafter to determine the size of the ablation area and search for recurrence in the thyroid parenchyma and lymph node metastasis. Thyroid function was examined before and 1 month after ablation. Fine needle aspiration biopsy was performed for any suspicious metastatic lymph nodes and recurrent lesions in the thyroid.

Results: All 105 lesions were completely inactivated after one ablation, making the success rate for single ablation 100%. The average ablation time was 2.78 ± 1.05 min, and the average ablation energy was 505 ± 185 J. All patients could tolerate and complete the ablation. No serious complications occurred during the treatment; only minor side effects such as pain and local discomfort were reported. The volume reduction rates were -781.14 ± 653.29% at 1 h posttreatment and -268.65 ± 179.57%, -98.39 ± 76.58%, 36.78 ± 30.32%, 75.55 ± 21.81%, 96.79 ± 10.57%, and 100% at 1, 3, 6, 12, 18, and 24 months after ablation, respectively. This rate remained 100% at the later follow-up times. Overall, 28 (26.67%), 74 (70.48%), 96 (91.43%), and 103 (100%) were completely absorbed by 6, 12, 18, and 24 months after PLA. One patient developed another lesion 12 months after ablation, and two patients had central cervical lymph node metastasis 24 months after ablation.

Conclusion: PLA is a safe and effective alternative clinical treatment for low-risk PTMC.

Citing Articles

Safety and efficacy of microwave ablation for the treatment of low-risk papillary thyroid microcarcinoma: a prospective multicenter study.

Han Z, Dou J, Zheng L, Che Y, Yu M, Wang S Eur Radiol. 2023; 33(11):7942-7951.

PMID: 37294329 DOI: 10.1007/s00330-023-09802-x.

The feasibility and efficacy of ultrasound-guided percutaneous laser ablation for multifocal papillary thyroid microcarcinoma.

Zhang L, Zhang G, Zhan W, Zhou W Front Endocrinol (Lausanne). 2022; 13:921812.

PMID: 36060950 PMC: 9428260. DOI: 10.3389/fendo.2022.921812.

Safety and efficacy of ultrasound-guided thermal ablation in treating T1aN0M0 and T1bN0M0 papillary thyroid carcinoma: A meta-analysis.

Wang M, Liu X, Wang Q, Zhang H Front Endocrinol (Lausanne). 2022; 13:952113.

PMID: 35966062 PMC: 9363616. DOI: 10.3389/fendo.2022.952113.

Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma.

Ou D, Chen C, Jiang T, Xu D Front Oncol. 2022; 12:859396.

PMID: 35847945 PMC: 9283792. DOI: 10.3389/fonc.2022.859396.

Pathogenic Factors Identification of Brain Imaging and Gene in Late Mild Cognitive Impairment.

Bi X, Li L, Xu R, Xing Z Interdiscip Sci. 2021; 13(3):511-520.

PMID: 34106420 DOI: 10.1007/s12539-021-00449-0.

References

Valcavi R, Piana S, Bortolan G, Lai R, Barbieri V, Negro R . Ultrasound-guided percutaneous laser ablation of papillary thyroid microcarcinoma: a feasibility study on three cases with pathological and immunohistochemical evaluation. Thyroid. 2013; 23(12):1578-82. DOI: 10.1089/thy.2013.0279. View

Vogl T, Straub R, Eichler K, Sollner O, Mack M . Colorectal carcinoma metastases in liver: laser-induced interstitial thermotherapy--local tumor control rate and survival data. Radiology. 2003; 230(2):450-8. DOI: 10.1148/radiol.2302020646. View

Valcavi R, Riganti F, Bertani A, Formisano D, Pacella C . Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid. 2010; 20(11):1253-61. DOI: 10.1089/thy.2010.0189. View

Achille G, Zizzi S, Di Stasio E, Grammatica A, Grammatica L . Ultrasound-guided percutaneous laser ablation in treating symptomatic solid benign thyroid nodules: Our experience in 45 patients. Head Neck. 2014; 38(5):677-82. DOI: 10.1002/hed.23957. View

Ito Y, Miyauchi A, Kudo T, Oda H, Yamamoto M, Sasai H . Trends in the Implementation of Active Surveillance for Low-Risk Papillary Thyroid Microcarcinomas at Kuma Hospital: Gradual Increase and Heterogeneity in the Acceptance of This New Management Option. Thyroid. 2018; 28(4):488-495. PMC: 5905421. DOI: 10.1089/thy.2017.0448. View

Liu W, Zhou P, Zhao Y, Tian S, Wu X . Superb Microvascular Imaging Compared with Contrast-Enhanced Ultrasound for Assessing Laser Ablation Treatment of Benign Thyroid Nodules. Biomed Res Int. 2019; 2018:1025657. PMC: 6323482. DOI: 10.1155/2018/1025657. View

Soares P, Celestino R, Gaspar da Rocha A, Sobrinho-Simoes M . Papillary thyroid microcarcinoma: how to diagnose and manage this epidemic?. Int J Surg Pathol. 2014; 22(2):113-9. DOI: 10.1177/1066896913517394. View

Zhang L, Zhou W, Zhan W, Peng Y, Jiang S, Xu S . Percutaneous Laser Ablation of Unifocal Papillary Thyroid Microcarcinoma: Utility of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Assessing Local Therapeutic Response. World J Surg. 2018; 42(8):2476-2484. DOI: 10.1007/s00268-018-4500-6. View

Gambelunghe G, Fede R, Bini V, Monacelli M, Avenia N, DAjello M . Ultrasound-guided interstitial laser ablation for thyroid nodules is effective only at high total amounts of energy: results from a three-year pilot study. Surg Innov. 2012; 20(4):345-50. DOI: 10.1177/1553350612459276. View

10.

Kang J, Kim E, Park Y, Park C, Yun J . A comparison of postoperative pain after conventional open thyroidectomy and single-incision, gasless, endoscopic transaxillary thyroidectomy: a single institute prospective study. Ann Surg Treat Res. 2017; 92(1):9-14. PMC: 5234429. DOI: 10.4174/astr.2017.92.1.9. View

11.

Caspani B, Ierardi A, Motta F, Cecconi P, Fesce E, Belli L . Small nodular hepatocellular carcinoma treated by laser thermal ablation in high risk locations: preliminary results. Eur Radiol. 2010; 20(9):2286-92. DOI: 10.1007/s00330-010-1766-y. View

12.

Weigel C, Kirsch M, Mensel B, Nerger U, Hosten N . [Percutaneous laser-induced thermotherapy of lung metastases: experience gained during 4 years]. Radiologe. 2004; 44(7):700-7. DOI: 10.1007/s00117-004-1083-z. View

13.

Londero S, Krogdahl A, Bastholt L, Overgaard J, Trolle W, Pedersen H . Papillary thyroid microcarcinoma in Denmark 1996-2008: a national study of epidemiology and clinical significance. Thyroid. 2013; 23(9):1159-64. DOI: 10.1089/thy.2012.0595. View

14.

Papini E, Guglielmi R, Gharib H, Hosseim G, Misischi I, Graziano F . Ultrasound-guided laser ablation of incidental papillary thyroid microcarcinoma: a potential therapeutic approach in patients at surgical risk. Thyroid. 2011; 21(8):917-20. PMC: 3148119. DOI: 10.1089/thy.2010.0447. View

15.

Ha E, Baek J, Kim K, Pyo J, Lee J, Baek S . Comparative efficacy of radiofrequency and laser ablation for the treatment of benign thyroid nodules: systematic review including traditional pooling and bayesian network meta-analysis. J Clin Endocrinol Metab. 2015; 100(5):1903-11. DOI: 10.1210/jc.2014-4077. View

16.

Pellegriti G, Frasca F, Regalbuto C, Squatrito S, Vigneri R . Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol. 2013; 2013:965212. PMC: 3664492. DOI: 10.1155/2013/965212. View

17.

Dobrinja C, Pastoricchio M, Troian M, Da Canal F, Bernardi S, Fabris B . Partial thyroidectomy for papillary thyroid microcarcinoma: Is completion total thyroidectomy indicated?. Int J Surg. 2017; 41 Suppl 1:S34-S39. DOI: 10.1016/j.ijsu.2017.02.012. View

18.

Chung Y, Choe J, Kang K, Kim S, Chung K, Park K . Endoscopic thyroidectomy for thyroid malignancies: comparison with conventional open thyroidectomy. World J Surg. 2007; 31(12):2302-6. DOI: 10.1007/s00268-007-9117-0. View

19.

Liu Z, Huang T . Papillary thyroid microcarcinoma and active surveillance. Lancet Diabetes Endocrinol. 2016; 4(12):974-975. DOI: 10.1016/S2213-8587(16)30269-8. View

20.

Zhou W, Jiang S, Zhan W, Zhou J, Xu S, Zhang L . Ultrasound-guided percutaneous laser ablation of unifocal T1N0M0 papillary thyroid microcarcinoma: Preliminary results. Eur Radiol. 2016; 27(7):2934-2940. DOI: 10.1007/s00330-016-4610-1. View