Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
J Formos Med Assoc. 2022 Aug;121(8):1406-1413. doi: 10.1016/j.jfma.2021.09.026. Epub 2021 Oct 15.
The incidence of papillary thyroid microcarcinoma (PTMC) has increased rapidly in recent decades, with a favorable overall prognosis. We aimed to evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for treating low-risk PTMC in Taiwan.
This prospective study included patients with PTMC who were ineligible or refused surgery and underwent US-guided RFA between October 2018 and June 2020. US and computed tomography (CT) were performed before RFA to assess tumor lesions and exclude cervical lymph node metastasis. Sequential US follow-up following RFA was performed after 1, 3, 6, and 12 months, and yearly thereafter. Volume reduction ratio (VRR) and complete disappearance rate of tumor at one year were evaluated.
13 PTMCs in 12 patients were enrolled with a mean follow-up of 16.2 ± 8.1 months (range, 1-24 months). The median largest tumor diameter and tumor volume before RFA were 0.76 cm and 0.15 ml (range, 0.02-0.37 ml). The median (interquartile range, IQR) volume and VRR at 12 months post-RFA were 0 (0, 0.03) ml (p = 0.033) and 100% (84.26%, 100%) (p = 0.008). Eight tumors (61.54%) were completely disappeared at 12 months post-RFA and no tumor recurrence, lymph nodes, or distant metastasis were noted. All tumors were successfully treated without complications.
Minimally invasive US-guided RFA is an effective and safe alternative for low-risk PTMC, resulting a satisfied VRR.
近年来,甲状腺微小乳头状癌(PTMC)的发病率迅速上升,整体预后良好。本研究旨在评估在台湾,超声(US)引导下射频消融(RFA)治疗低危 PTMC 的疗效和安全性。
本前瞻性研究纳入了 2018 年 10 月至 2020 年 6 月期间因不符合手术条件或拒绝手术而接受 US 引导下 RFA 治疗的 PTMC 患者。RFA 前进行 US 和计算机断层扫描(CT)检查,以评估肿瘤病变并排除颈部淋巴结转移。RFA 后 1、3、6 和 12 个月以及此后每年进行连续 US 随访,评估肿瘤体积缩小率(VRR)和肿瘤一年后的完全消失率。
共纳入 12 例患者的 13 个 PTMC,中位随访时间为 16.2±8.1 个月(范围 1-24 个月)。RFA 前的中位最大肿瘤直径和肿瘤体积分别为 0.76cm 和 0.15ml(范围 0.02-0.37ml)。RFA 后 12 个月的中位(四分位间距,IQR)体积和 VRR 分别为 0(0,0.03)ml(p=0.033)和 100%(84.26%,100%)(p=0.008)。12 个月后 8 个肿瘤(61.54%)完全消失,无肿瘤复发、淋巴结或远处转移。所有肿瘤均成功治疗,无并发症。
微创的 US 引导下 RFA 是治疗低危 PTMC 的有效且安全的替代方法,可获得满意的 VRR。