Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer.

OBJECTIVES

To assess the efficacy and safety of ultrasound- (US) guided radiofrequency ablation (RFA) for controlling locoregional recurrent papillary thyroid cancer (PTC) in a large patient population.

METHODS

We included patients who had undergone RFA for locoregional recurrent PTC between September 2008 and April 2012 who fulfilled the following criteria: no metastasis beyond the neck; not more than four tumours; confirmed recurrence by US-guided fine needle aspiration biopsy or thyroglobulin measurement of needle washouts; more than a six-month follow-up period; and surgery not feasible or was refused by the patient.

RESULTS

Sixty-one recurrent tumours in 39 patients were included. The mean follow-up duration was 26.4 ± 13.7 months. Tumour volume decreased significantly from 0.20 ± 0.35 ml before ablation to 0.02 ± 0.11 ml (P < .001), with a mean volume reduction ratio of 95.1 ± 12.3%. Fifty tumours (82.0%) completely disappeared. Eleven tumours were visible at last follow-up US. The mean serum thyroglobulin level decreased from 1.21 ± 1.91 to 0.50 ± 0.80 ng/ml (P = .001). The overall complication rate was 7.7% (3/39).

CONCLUSIONS

RFA can effectively control locoregional recurrent PTC without life-threatening complications; therefore, RFA may replace "berry picking surgery" in selected patients.

KEY POINTS

• RFA for recurrent PTC achieved a volume reduction ratio of 95.1 ± 12.3% • Eighty-two percent (50/61) of recurrent PTC completely disappeared after RFA • The mean serum thyroglobulin level decreased significantly (P = .001) after RFA • RFA may replace "berry picking surgery" for recurrent PTC.