Skip to main content

Advertisement

Log in

Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer

  • Head and Neck
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this study was to evaluate the longer-term efficacy of ultrasound (US)-guided radiofrequency ablation (RFA) for treating locally recurrent papillary thyroid cancer (PTC).

Methods

We retrospectively reviewed 29 patients who underwent RFA for 46 recurrent PTC between September 2008 and April 2012 and were subsequently followed up for at least 5 years. Follow-up included size change on US and thyroglobulin (Tg) level at 1, 3, 6, and 12 months and every 6–12 months thereafter. Any complications were reported during follow-up.

Results

The mean follow-up duration after RFA was 80 ± 17.3 months (range, 60–114 months). Tumor volume decreased significantly, from 0.25 ± 0.42 mL before ablation to 0.01 ± 0.08 mL at the final evaluation (p < 0.001), with a mean volume reduction of 99.5% ± 2.9%. Forty-two of the 46 treated tumors (91.3%) had completely disappeared by the final evaluation. The mean serum Tg level decreased from 2.55 ± 4.7 to 0.75 ± 1.83 ng/dL (p < 0.001). There were no delayed complications associated with RFA during the follow-up period.

Conclusions

RFA seems to be an effective minimally invasive therapy for the treatment of locally recurrent PTC even in the longer-term period.

Key Points

RFA is an effective local control treatment option for recurrent PTCs even in the longer-term period with mean tumor VRR of 99.5% and the complete disappearance of the treated tumors in 91.3%.

The mean serum Tg level decreased significantly after RFA and biochemical remission rate was 51.7%.

No delayed complication after RFA for local recurrent PTC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

CT:

Computed tomography

EA:

Ethanol ablation

FNAB:

Fine-needle aspiration biopsy

PTC:

Papillary thyroid carcinoma

RFA:

Radiofrequency ablation

Tg:

Thyroglobulin

US:

Ultrasound

VRR:

Volume reduction rate

References

  1. Siegel R, DeSantis C, Virgo K et al (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62:220–241

    Article  PubMed  Google Scholar 

  2. Hay ID, Thompson GB, Grant CS et al (2002) Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940-1999): temporal trends in initial therapy and long-term outcome in 2444 consecutively treated patients. World J Surg 26:879–885

    Article  PubMed  Google Scholar 

  3. Samaan NA, Schultz PN, Hickey RC et al (1992) The results of various modalities of treatment of well differentiated thyroid carcinomas: a retrospective review of 1599 patients. J Clin Endocrinol Metab 75:714–720

    CAS  PubMed  Google Scholar 

  4. Baek JH, Kim YS, Sung JY, Choi H, Lee JH (2011) Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. AJR Am J Roentgenol 197:W331–W336

    Article  PubMed  Google Scholar 

  5. Park KW, Shin JH, Han BK, Ko EY, Chung JH (2011) Inoperable symptomatic recurrent thyroid cancers: preliminary result of radiofrequency ablation. Ann Surg Oncol 18:2564–2568

    Article  PubMed  Google Scholar 

  6. Lee SJ, Jung SL, Kim BS et al (2014) Radiofrequency ablation to treat loco-regional recurrence of well-differentiated thyroid carcinoma. Korean J Radiol 15:817–826

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wang L, Ge M, Xu D et al (2014) Ultrasonography-guided percutaneous radiofrequency ablation for cervical lymph node metastasis from thyroid carcinoma. J Cancer Res Ther 10(Suppl):C144–C149

    PubMed  Google Scholar 

  8. Kim JH, Yoo WS, Park YJ et al (2015) Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology 276:909–918

    Article  PubMed  Google Scholar 

  9. Kim BM, Kim MJ, Kim EK, Park SI, Park CS, Chung WY (2008) Controlling recurrent papillary thyroid carcinoma in the neck by ultrasonography-guided percutaneous ethanol injection. Eur Radiol 18:835–842

    Article  PubMed  Google Scholar 

  10. Heilo A, Sigstad E, Fagerlid KH et al (2011) Efficacy of ultrasound-guided percutaneous ethanol injection treatment in patients with a limited number of metastatic cervical lymph nodes from papillary thyroid carcinoma. J Clin Endocrinol Metab 96:2750–2755

    Article  CAS  PubMed  Google Scholar 

  11. Hay ID, Lee RA, Davidge-Pitts C, Reading CC, Charboneau JW (2013) Long-term outcome of ultrasound-guided percutaneous ethanol ablation of selected “recurrent” neck nodal metastases in 25 patients with TNM stages III or IVA papillary thyroid carcinoma previously treated by surgery and 131I therapy. Surgery 154:1448–1454 discussion 1454-1445

    Article  PubMed  Google Scholar 

  12. Haugen BR, Alexander EK, Bible KC et al (2016) 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 26:1–133

    Article  PubMed  PubMed Central  Google Scholar 

  13. Yi KH, Lee EK, Kang HC et al (2016) 2016 Revised Korean Thyroid Association management guidelines for patients with thyroid nodules and thyroid cancer. Int J Thyroidol 9:59–126

    Article  Google Scholar 

  14. Suh CH, Baek JH, Choi YJ, Lee JH (2016) Efficacy and safety of radiofrequency and ethanol ablation for treating locally recurrent thyroid cancer: a systematic review and meta-analysis. Thyroid 26:420–428

    Article  CAS  PubMed  Google Scholar 

  15. Lim HK, Baek JH, Lee JH et al (2015) Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer. Eur Radiol 25:163–170

    Article  PubMed  Google Scholar 

  16. Jeong WK, Baek JH, Rhim H et al (2008) Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 18:1244–1250

    Article  PubMed  Google Scholar 

  17. Park HS, Baek JH, Choi YJ, Lee JH (2017) Innovative techniques for image-guided ablation of benign thyroid nodules: combined ethanol and radiofrequency ablation. Korean J Radiol 18:461–469

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kim JH, Baek JH, Lim HK et al (2018) 2017 thyroid radiofrequency ablation guideline: Korean Society of Thyroid Radiology. Korean J Radiol 19:632–655

    Article  PubMed  PubMed Central  Google Scholar 

  19. Guenette JP, Monchik JM, Dupuy DE (2013) Image-guided ablation of postsurgical locoregional recurrence of biopsy-proven well-differentiated thyroid carcinoma. J Vasc Interv Radiol 24:672–679

    Article  PubMed  Google Scholar 

  20. Dobrinja C, Bernardi S, Fabris B et al (2015) Surgical and pathological changes after radiofrequency ablation of thyroid nodules. Int J Endocrinol 2015:576576

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Kim SY, Kim SM, Chang H et al (2017) Long-term outcomes of ethanol injection therapy for locally recurrent papillary thyroid cancer. Eur Arch Otorhinolaryngol 274:3497–3501

    Article  PubMed  Google Scholar 

  22. Shaha AR (2012) Recurrent differentiated thyroid cancer. Endocr Pract 18:600–603

    Article  PubMed  Google Scholar 

  23. Forrest JB, Rehder K, Cahalan MK, Goldsmith CH (1992) Multicenter study of general anesthesia. III. Predictors of severe perioperative adverse outcomes. Anesthesiology 76:3–15

    Article  CAS  PubMed  Google Scholar 

  24. Lim CY, Yun JS, Lee J, Nam KH, Chung WY, Park CS (2007) Percutaneous ethanol injection therapy for locally recurrent papillary thyroid carcinoma. Thyroid 17:347–350

    Article  CAS  PubMed  Google Scholar 

  25. Burman KD (2012) Treatment of recurrent or persistent cervical node metastases in differentiated thyroid cancer: deceptively simple options. J Clin Endocrinol Metab 97:2623–2625

    Article  CAS  PubMed  Google Scholar 

  26. Kim MK, Mandel SH, Baloch Z et al (2004) Morbidity following central compartment reoperation for recurrent or persistent thyroid cancer. Arch Otolaryngol Head Neck Surg 130:1214–1216

    Article  PubMed  Google Scholar 

  27. Al-Saif O, Farrar WB, Bloomston M, Porter K, Ringel MD, Kloos RT (2010) Long-term efficacy of lymph node reoperation for persistent papillary thyroid cancer. J Clin Endocrinol Metab 95:2187–2194

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Chung SR, Suh CH, Baek JH, Park HS, Choi YJ, Lee JH (2017) Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperthermia 33:920–930

    PubMed  Google Scholar 

  29. Ha EJ, Baek JH, Lee JH (2015) Ultrasonography-based thyroidal and perithyroidal anatomy and its clinical significance. Korean J Radiol 16:749–766

    Article  PubMed  PubMed Central  Google Scholar 

  30. Shin JH, Baek JH, Ha EJ, Lee JH (2012) Radiofrequency ablation of thyroid nodules: basic principles and clinical application. Int J Endocrinol 2012:919650

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jung Hwan Baek.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Jung Hwan Baek.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

We previously reported the outcome of RFA for locally recurrent PTC after a mean follow-up period of 26.4 months, finding that RFA appears to effectively control locoregional recurrence. This study, an extension of our previous report, analyzed the outcomes of RFA after > 5 years of follow-up.

Lim HK et al. Eur Radiol. 2015;25:163–170

Methodology

• retrospective

• observational

• performed at one institution

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chung, S.R., Baek, J.H., Choi, Y.J. et al. Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. Eur Radiol 29, 4897–4903 (2019). https://doi.org/10.1007/s00330-019-06063-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-019-06063-5

Keywords

Navigation