Department of Ultrasound, First Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2021 May 18;12:624054. doi: 10.3389/fendo.2021.624054. eCollection 2021.
To evaluate the safety and efficacy of radiofrequency ablation (RFA) for metastatic lymph nodes (LNs) in children and adolescents with papillary Thyroid Carcinoma (PTC).
From 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.
All 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 ( = 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.
As 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.
评估射频消融（RFA）治疗儿童和青少年甲状腺乳头状癌（PTC）转移性淋巴结（LNs）的安全性和疗效。
从 2014 年 12 月至 2018 年 3 月，对 5 例（3 例女性，2 例男性；平均年龄 15.60 ± 2.97 岁，范围 12-19 岁）患有 PTC 的儿童和青少年的 10 个转移性 LNs（平均体积 0.30 ± 0.38ml，范围 0.06-1.23ml）进行了 RFA 治疗。在 RFA 之前，平均进行了 1.2 次（范围 1-2 次）手术，每位患者的平均治疗转移性 LNs 数量为 2 个（范围 1-3 个）。RFA 在局部麻醉下使用 18G 双极 RF 应用器进行。随访包括超声和血清甲状腺球蛋白（Tg）水平在 1、3、6、12 个月以及此后每 12 个月。
所有患者均能耐受 RFA 手术，无手术相关并发症发生。在平均 52.00 ± 21.44 个月的随访期间，LNs 的初始体积为 0.30 ± 0.38ml，明显减少至 0.01 ± 0.03ml（ = 0.005），平均 VR 为 99.28 ± 2.27%。共有 9 个（90.00%）转移性 LNs 完全消失。RFA 后，2 例患者出现新的转移。1 例患者进行了额外的 RFA。另一位患有多个 LNs 转移的患者接受了全甲状腺切除术和中央颈部淋巴结清扫术。
作为一种微创且有效的技术，RFA 可能为儿童和青少年 PTC 颈转移性 LNs 的现有治疗方法提供另一种选择。
