Radiofrequency ablation: A viable option for some with thyroid cancer, as well as thyroid nodules and parathyroid adenoma.
The future is here!
- RFA is clearly indicated for symptomatic or cosmetic problems of benign nodules.
- Micropapillary cancers <1.5 cm can be RF ablated if the patient refuses surgery or Active surveillance.
- RFA can be used in cases with bulky nodular goiters to relieve symptoms.
- Parathyroid adenomas located in the inferior location can be RF ablated if the patient refuses surgery.
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- Dr.G. is doing Thyroid RF in his office.
“The first paper on radiofrequency ablation was published in 2006 and soon after, the technique slowly began gaining traction. In 2015, my colleagues and I began performing the technique and use of radiofrequency ablation continues to steadily grow today in the U.S. and elsewhere,” Leonardo G. Rangel, MD, physician at State University of Rio de Janeiro in Brazil, said during a presentation.
“Radiofrequency ablation in these patients, with good results and will restore thyroid function,” Rangel said. “Although surgery could be indicated, radiofrequency ablation is a viable option, with benefits regarding risks, costs and recovery.” The scar is a major drawback for most thyroid surgeries
A good patient-candidate is one who would otherwise be followed-up for some time, according to Rangel.
“In these patients, radiofrequency ablation could interrupt the pathologic process of cancer growth and treat the nodule at the most effective time,” he said. “While surgery can be expected at some point for these patients, the risks and benefits should be weighed in anticipation of performing radiofrequency ablation.”
A patient who is considered a fair candidate is one who has a dominant nodule as part of the thyroid problem. “For these patients, radiofrequency ablation will not lead to a problem-free future,” Rangel said.
Questions remain for radiofrequency ablation in patients with malignant papillary thyroid cancer, he said.
“We are still unsure if radiofrequency ablation destroys all viable cells, prevents progression and reduces follow-up in these patients,” Rangel said.
Additionally, data on patients with parathyroid disease is are scarce, according to Rangel, and more research is needed.
Helio– by Jennifer Southall
Rangel LG, et al. Early Riser Symposium: Cutting edge concepts in the management of thyroid disease: The future is here. Presented at: Annual Meeting of the American Thyroid Association; Oct. 30-Nov. 3, 2019; Chicago.