Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Front Endocrinol (Lausanne). 2022 Aug 3;13:933931. doi: 10.3389/fendo.2022.933931. eCollection 2022.
The application of radiofrequency ablation (RFA) for recurrent thyroid cancer has been demonstrated to effectively manage lesions at critical locations, such as abutting the trachea, with limited complications. Comprehensive investigation of both biochemical (B) and structural (S) change after RFA remains limited. We herein present the first single-center experience of RFA for the treatment of locoregional recurrent thyroid cancer in Taiwan.
23 patients were enrolled, and the treatment responses after RFA were divided into four groups (, , , and ), and then compared. The RFA technique, follow-up strategy, changes in pre-and post-operative status, and complications are presented. The volume reduction rate at 1, 3, and 6 months, and the differing responses between lesions abutting/not abutting the trachea are also discussed.
In patients with pre-RFA structural and biochemical incomplete () status, presenting with lesion with an initial maximum diameter of >3.2cm, a higher rate of structural incomplete status at the 6-month follow-up was noted in ROC analysis, with a sensitivity of 57% and specificity of 91%. Favorable structural remission after RFA was noted, and 60.9% of patients achieved biochemical complete status. No significant correlation was noted between the trachea-abutted lesion number and complete remission (p= 0.474). No significant difference in RFA efficacy was noted between the lesions abutting/not abutting the trachea.
This retrospective study reveals that RFA can achieve both structural and biochemical improvements for locoregionally recurrent thyroid cancer, with a low complication rate. Nearly half of the patients achieved an excellent response after RFA, while a favorable treatment response can be achieved despite the lesion abutting the trachea, with a mean VRR of 84.74%.
射频消融（RFA）在治疗毗邻气管等关键部位复发性甲状腺癌方面的应用已被证实可有效控制病灶，且并发症有限。但对 RFA 后生化（B）和结构（S）变化的综合评估仍有限。本文介绍了台湾首例 RFA 治疗局部复发性甲状腺癌的单中心经验。
共纳入 23 例患者，根据 RFA 后治疗反应分为四组（A、B、C 和 D），然后进行比较。介绍了 RFA 技术、随访策略、术前术后状态变化以及并发症。还讨论了 1、3 和 6 个月时的体积缩小率，以及毗邻/不毗邻气管的病灶之间的不同反应。
在 RFA 前存在结构和生化不完全缓解（）的患者中，初始最大直径>3.2cm 的病灶，其 6 个月随访时结构不完全缓解的比例更高，ROC 分析的敏感性为 57%，特异性为 91%。RFA 后结构缓解良好，60.9%的患者达到生化完全缓解。与完全缓解（p=0.474）无明显相关性。毗邻气管的病灶数量与完全缓解之间无明显差异。
这项回顾性研究表明，RFA 可使局部复发性甲状腺癌的结构和生化改善，并发症发生率低。近一半的患者在 RFA 后获得了良好的反应，即使病灶毗邻气管，也能获得良好的治疗反应，平均 VRR 为 84.74%。
