Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China.
Department of Thyroid, Beijing Beicheng Chinese Medicine Hospital, Beijing, China.
J Clin Endocrinol Metab. 2021 Jan 23;106(2):e573-e581. doi: 10.1210/clinem/dgaa776.
Ultrasound-guided thermal ablation plays an important role in the management of thyroid disease. The objective of this study was to evaluate the feasibility, efficacy, and safety of thermal ablation for patients with solitary T1bN0M0 papillary thyroid carcinoma (PTC) who are ineligible for or unwilling to undergo surgery.
Data pertaining to 172 patients (38 males and 134 females) who received thermal ablation therapy at 12 hospitals between April 2015 and March 2020 were retrospectively analyzed. The mean duration of follow-up was 24.9 ± 14.1 months (range, 12-60). The technical feasibility, technical success, efficacy, and safety of treatment were analyzed. Postablation tumor size at various time points was compared with preablation measurement.
All patients selected for thermal ablation received enlarged ablation, according to contrast-enhanced ultrasound postablation. The maximum diameter and volume of ablation zone at 6, 12, 18, 24, 36, and 48 months postablation were significantly smaller than those recorded preablation (P < 0.05 for all). At the most recent follow-up, 106 (61.6%) tumors had completely disappeared. The rate of lymph node metastasis was 0.6% (1/172) and the incidence of new tumors was 1.2% (2/172). The overall complication rate was 5.2% (9/172) (major complications: 4.6% [8/172]; minor complications: 0.6% [1/172]). All major complications were relieved within 4 months postablation.
Thermal ablation may be a feasible, effective, and safe treatment option for patients with solitary T1bN0M0 PTC who are ineligible for or unwilling to undergo surgery. It may provide a novel treatment option for selected patients.
超声引导下热消融在甲状腺疾病的治疗中起着重要作用。本研究旨在评估对不适合或不愿手术的 T1bN0M0 期单发甲状腺乳头状癌（PTC）患者进行热消融治疗的可行性、疗效和安全性。
回顾性分析了 2015 年 4 月至 2020 年 3 月期间在 12 家医院接受热消融治疗的 172 例患者（38 例男性和 134 例女性）的数据。平均随访时间为 24.9±14.1 个月（范围 12-60 个月）。分析了治疗的技术可行性、技术成功率、疗效和安全性。比较了消融前后各时间点肿瘤的大小。
所有选择热消融的患者均根据消融后增强超声进行了扩大消融。消融后 6、12、18、24、36 和 48 个月时，消融区的最大直径和体积明显小于消融前（所有 P<0.05）。最近一次随访时，106 例（61.6%）肿瘤完全消失。淋巴结转移率为 0.6%（1/172），新发肿瘤率为 1.2%（2/172）。总并发症发生率为 5.2%（9/172）（主要并发症：4.6%[172 例]；次要并发症：0.6%[172 例]）。所有主要并发症均在消融后 4 个月内缓解。
对于不适合或不愿手术的 T1bN0M0 期单发甲状腺乳头状癌患者，热消融可能是一种可行、有效且安全的治疗选择。它可为选定的患者提供一种新的治疗选择。
