Radiofrequency Ablation of Low-Risk Papillary Thyroid Microcarcinoma: A Retrospective Cohort Study Including Patients with More than 10 Years of Follow-up
Authors' conclusion
In our experience, RFA of low-risk PTMC is effective and safe. During more than 10 years of follow-up, we observed no incident local tumor progression nor metastases, but 7.7% of patients developed a new papillary thyroid cancer.
Study context
- Population
- Patients with low-risk papillary thyroid microcarcinoma (PTMC) unsuitable for or declining surgery, with >10 years of follow-up after ultrasound (US)-guided radiofrequency ablation (RFA); 71 low-risk PTMCs; 60 unifocal, 5 multifocal
- Participants
- 65 patients71 low-risk PTMCs
- Outcome
- Cumulative rates of disease progression (local tumor progression, lymph node or distant metastasis), newly developed thyroid cancer, and conversion surgery
- Follow-up
- Median 151 months (IQR 131-157)
Methodological detailssingle-group, consecutive patients, US-guided RFA, Repeat RFA for staged ablation when the first RFA did not secure sufficient safety margins due to tumor abutting the recurrent laryngeal nerve, Follow-up US at 1 week, 3 months, 6 months, every 6 months until 2 years, then annually
- Single-group
- Consecutive patients
- US-guided RFA
- Repeat RFA for staged ablation when the first RFA did not secure sufficient safety margins due to tumor abutting the recurrent laryngeal nerve
- Follow-up US at 1 week, 3 months, 6 months, every 6 months until 2 years, then annually
Main finding
As reported in the abstract
median follow-up 151 months
Disease progression
0
New papillary thyroid cancer (four treated with RFA, one with lobectomy)
5/65, 7.7%
Observational data: associations, not effects.
Secondary outcomes
Mean volume reduction rate (VRR) · 24 months
- Mean VRR at 24 months, maintained throughout final follow-up
- 100%
Complete tumor disappearance after ≥1 RFA · 6, 12 and 24 months
- 6 months
- 40.8% (29/71)
- 12 months
- 74.6% (53/71)
- 24 months
- 100% (71/71)
Repeat RFA required
- Patients requiring repeat RFA
- Twenty percent (13/65)
- Mean RFA sessions per tumor
- 1.2
Safety
- Major adverse event (SCH)
- 1
- Minor adverse events
- 3
Original publication
Radiofrequency Ablation of Low-Risk Papillary Thyroid Microcarcinoma: A Retrospective Cohort Study Including Patients with More than 10 Years of Follow-up. Thyroid. Published 27 January 2025. doi:10.
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