Thyroid Cancer Alternative Therapy 101: Ethanol PEI and radiofrequency ablation RFA

Thyroid Cancer Alternative Therapy 101: Ethanol PEI and radiofrequency ablation RFA

Thyroid Cancer Alternative Therapy 101: Ethanol PEI and radiofrequency ablation RFA

Thyroid Cancer Alternative Therapy 101: Ethanol PEI and radiofrequency ablation RFA.

Dr.Guttler’s Comments on this article.

1.When thyroid cancer recurs, it is typically found within the surgical bed or in lymph nodes of the central or lateral compartments.

2.Recurrence in the central compartment can be either in lymph nodes or in the thyroid bed.

3.A recurrence in the thyroid bed results in increased rates of morbidity and mortality.

4.Recurrence in the lateral compartment usually occurs as lymph node metastasis. Surgery is recommended for recurrence in the central or lateral compartments of the neck that can be identified by ultrasonography (US)

5.Reoperative surgery in the central or lateral compartments of the neck in patients who have undergone a previous neck dissection is difficult, however, due to distortion of normal tissue planes by scar tissue formation within the surgical bed, and such operations are subsequently associated with a higher rate of complications.

6.Percutaneous radiofrequency ablation (RFA) and percutaneous ethanol (EtOH) injection are relatively new, minimally-invasive techniques that have been widely used as alternatives to surgical treatment in patients with hepatocellular carcinoma or liver metastasis from other malignancies.

7.RFA and EtOH injection with local anesthesia have been reported as alternatives to surgery in patients with local recurrence of thyroid cancer.

8.Surgery is the gold standard for treatment of recurrent WTC in the central or lateral compartments of the neck.

9.RFA and EtOH ablation are very exciting and show promise as minimally invasive alternatives to surgical treatment in some patients.

Ann Surg. 2006 Aug; 244(2): 296–304.

Radiofrequency Ablation and Percutaneous Ethanol Injection Treatment for Recurrent Local and Distant Well-Differentiated Thyroid Carcinoma
Jack M. Monchik, MD,et al

Lymph node before PEI treatment.

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CONCLUSION

Surgery is the gold standard for treatment of recurrent WTC in the central or lateral compartments of the neck. Our results with RFA and EtOH ablation are very exciting and show promise as minimally invasive alternatives to surgical treatment in some patients. RFA also shows promise as an effective treatment modality for focal distant metastases of WTC. Further long-term follow-up studies are necessary to determine the precise role these therapies should play in the treatment of recurrent WTC and whether certain more invasive surgical procedures can be replaced.

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