Comments by Dr.Guttler
1.In thyroid gland, radiofrequency ablation (RFA) has been applied to both recurrent cancers and benign nodules.
2. Surgery is the first-line treatment for follicular neoplasm.
3. However, it has been argued that follicular neoplasm with lower risk of malignancy can be managed by close follow-up.
4. RFA of small follicular neoplasms, examining reductions in volume and related clinical problems, and making observations over long-term follow-up.
5. 10 patients who were treated with RF ablation between 2009 and 2011.
6. A RF generator and an 18-gauge internally cooled electrode were used to perform complete ablation of the whole nodules.
7. Changes in nodules or ablated zones on follow-up ultrasound, and complications during and after RF ablation were evaluated.
8. 66.4 ± 5.1 months (range: 60–76 months) follow up periods. 9. In eight patients, single session of RF ablation was sufficient, while two patients required two sessions.
10.There was a significant reduction in the mean volume (99.5 ± 1.0%) of lesions.
11. (8/10, 80%) disappearing completely on follow-up.
12.No recurrences were found in any ablated zones at last follow-up.
13. Transient mild neck pain (n = 6) occurred during the procedure without requiring any medication.
RFA complications for all type cases. Small primary neoplasms inside the thyroid should and do show less serious complications.
14 In addition to active surveillance, RF ablation may be an effective and safe alternative for the management of patients with small (<2 cm) follicular neoplasm suspected on thyroid biopsy and who strongly refuse surgery.
Comments: This is the future of thyroid cancer treatment in the US for these small tumors.Now both ethanol PEI and RFA have shown they can ablate these without major complications.
Ian Hay at the Mayo clinic has presented 14 cases with micro-papillary ca treated with ethanol PEI.
If you are interested in avoiding surgery or the long follow up offered by Active surveillance we can do ethanol ablation PEI in my center.
Also I can evaluated you for possible Thyroid RFA treatment in Korea with
Dr.JH Baek and his staff at Asan Medical Center in Seoul.
Call Matt at 310-393-8860 or firstname.lastname@example.org for details.
Richard Guttler MD,FACE,ECNU