A Single Center Retrospective Analysis of Patients with Recurrent Papillary Thyroid Carcinoma Undergoing Radiofrequency Ablation

Year 2022, Volume: 4 - Supplement 1, 1 - 6, 01.04.2022

Erhan Hocaoğlu , Ensar Aydemir , Coşkun Ateş , Filiz Mercan Sarıdaş , Omer Fatih Nas , Mehmet Fatih İnecikli , Soner Cander , Özen Öz Gül , Erdinç Ertürk , Canan Ersoy

https://doi.org/10.46310/tjim.1073526

Abstract

Background: Radiofrequency ablation (RFA) is used in selected patients with recurrent or metastatic thyroid cancer who have high surgical risk or do not accept surgical treatment. However, long-term follow-up data are limited. Here, we present our single-center experience with the use of RFA in the treatment of recurrent or metastatic papillary thyroid carcinoma (PTC).
Material and Methods: Patients who underwent RFA for recurrent or metastatic PTC at Bursa Uludag University Faculty of Medicine between September 2014 and January 2021 were included. The data in the endocrinology outpatient clinic follow-ups of the patients were analyzed retrospectively.
Results: A total of 10 patients, 11 RFA procedures, and 13 residual or metastatic sites were evaluated. The mean age was 44.50±14.04 years. The mean largest diameter of the tumor in which RFA was applied was 11.85±5.95 mm. Patients developed no major complications. Two patients experienced minor complications. The mean follow-up duration was of 51.20±19.86 months. During the follow-up period, 12 (92.30%) of 13 RFA sites completely disappeared. In one patient (7.69%) residual tumor tissue was detected after RFA. There was no recurrence at the procedure site. A significant decrease was found in the largest diameter of the treated regions after RFA (p=0.002). Thyroglobulin and anti-thyroglobulin levels were not significantly different before and after RFA (p=0.44 and p=1.00, respectively).
Conclusions: RFA is highly effective and safe for locally recurrent PTC. It shows promise as an alternative to surgery to control locoregional recurrence of PTC.

Keywords

radiofrequency ablation, papillary thyroid cancer, recurrent thyroid cancer

References

• Lajtai K, Nagy CT, Tarszabó R, Benkő R, Hadjadj L, Sziva Fugazzola L, Elisei R, Fuhrer D, Jarzab B, Leboulleux S, Newbold K, Smit J. 2019 European Thyroid Association Guidelines for the treatment and follow-up of advanced radioiodine-refractory thyroid cancer. Eur Thyroid J. 2019 Oct;8(5):227-45. doi: 10.1159/000502229.
• La Vecchia C, Malvezzi M, Bosetti C, Garavello W, Bertuccio P, Levi F, Negri E. Thyroid cancer mortality and incidence: A global overview. Int J Cancer. 2015 May 1; 136(9):2187-95. doi: 10.1002/ijc.29251.
• Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394-424. doi: 10.3322/caac.21492. [Erratum: Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2020 Jul;70(4):313. doi: 10.3322/caac.21609].
• Monchik JM, Donatini G, Iannuccilli J, Dupuy DE. Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well- differentiated thyroid carcinoma. Ann Surg. 2006 Aug; 244(2):296-304. doi: 10.1097/01.sla.0000217685.85467.2d.
• Tufano RP, Pace-Asciak P, Russell JO, Suárez C, Randolph GW, López F, Shaha AR, Mäkitie A, Rodrigo JP, Kowalski LP, Zafereo M, Angelos P, Ferlito A. Update of radiofrequency ablation for treating benign and malignant thyroid nodules. The future is now. Front Endocrinol (Lausanne). 2021 Jun 24;12:698689. doi: 10.3389/ fendo.2021.698689.
• Mauri G, Hegedüs L, Bandula S, Cazzato RL, Czarniecka A, Dudeck O, Fugazzola L, Netea-Maier R, Russ G, Wallin G, Papini E. European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 Clinical Practice Guideline for the use of minimally invasive treatments in malignant thyroid lesions. Eur Thyroid J. 2021 Jun;10(3):185-97. doi: 10.1159/000516469.
• Triponez F, Poder L, Zarnegar R, Goldstein R, Roayaie K, Feldstein V, Lee J, Kebebew E, Duh QY, Clark OH. Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments: a safe technique for small, nonpalpable recurrent disease. J Clin Endocrinol Metab. 2006 Dec;91(12):4943-7. doi: 10.1210/ jc.2006-0386.
• Muhammad H, Tehreem A, Russell JO. Radiofrequency ablation and thyroid cancer: review of the current literature. Am J Otolaryngol. Jan-Feb 2022;43(1):103204. doi: 10.1016/j.amjoto.2021.103204.
• Shin JE, Baek JH, Lee JH. Radiofrequency and ethanol ablation for the treatment of recurrent thyroid cancers: current status and challenges. Curr Opin Oncol. 2013 Jan;25(1):14-9. doi: 10.1097/CCO.0b013e32835a583d.
• Pacella CM, Papini E. Image-guided percutaneous ablation therapies for local recurrences of thyroid tumors. J Endocrinol Invest. 2013 Jan;36(1):61-70. doi: 10.1007/ BF03346744.
• Lim HK, Baek JH, Lee JH, Kim WB, Kim TY, Shong YK, Hong SJ. Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer. Eur Radiol. 2015 Jan;25(1):163-70. doi: 10.1007/ s00330-014-3405-5.
• Chung SR, Baek JH, Choi YJ, Lee JH. Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. Eur Radiol. 2019 Sep;29(9):4897- 903. doi: 10.1007/s00330-019-06063-5.
• Kim JH, Yoo WS, Park YJ, Park DJ, Yun TJ, Choi SH, Sohn CH, Lee KE, Sung MW, Youn YK, Kim KH, Cho BY. Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology. 2015 Sep;276(3):909-18. doi: 10.1148/ radiol.15140079.
• Yan L, Zhang M, Song Q, Xiao J, Zhang Y, Luo Y. The efficacy and safety of radiofrequency ablation for bilateral papillary thyroid microcarcinoma. Front Endocrinol (Lausanne). 2021 Jun 11;12:663636. doi: 10.3389/ fendo.2021.663636.
• Zhu Y, Che Y, Gao S, Ren S, Tong M, Wang L, Yang F. Long-term follow-up results of PTMC treated by ultrasound-guided radiofrequency ablation: a retrospective study. Int J Hyperthermia. 2021;38(1):1225-32. doi: 10.1080/02656736.2021.1963850.
• Park KW, Shin JH, Han BK, Ko EY, Chung JH. Inoperable symptomatic recurrent thyroid cancers: preliminary result of radiofrequency ablation. Ann Surg Oncol. 2011 Sep;18(9):2564-8. doi: 10.1245/s10434-011-1619-1.
• Zhao Q, Tian G, Kong D, Jiang T. Meta-analysis of radiofrequency ablation for treating the local recurrence of thyroid cancers. J Endocrinol Invest. 2016 Aug;39(8):909- 16. doi: 10.1007/s40618-016-0450-8.
• Chung SR, Suh CH, Baek JH, Park HS, Choi YJ, Lee JH. Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperthermia. 2017 Dec;33(8):920-30. doi: 10.1080/02656736.2017.1337936.
• Ringel MD, Nabhan F. Approach to follow-up of the patient with differentiated thyroid cancer and positive anti- thyroglobulin antibodies. J Clin Endocrinol Metab. 2013 Aug;98(8):3104-10. doi: 10.1210/jc.2013-1412.
• Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Scchuff KG, Sherman S, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016 Jan;26(1):1-133. doi:10.1089/thy.2015.0020.