Thyroid Cancer No Surgery 101: Use of Thyroid Radiofrequency Ablation for Primary Thyroid Cancers
Reference: Jeong. et al
International J.Hyperthermia 33(8)938-45 2017
Ethanol and thermal ablation for malignant thyroid tumors
Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid malignancy and has a good prognosis and low mortality rate. Surgery is the standard treatment for patients with primary and recurrent thyroid cancer. Although patients with PTC usually exhibit excellent treatment outcome, the incidence of recurrence in the neck ranges from 20% to 59%. When a patient with thyroid cancer is contraindicated for surgery, ultrasound (US)-guided ablation techniques, including ethanol ablation (EA) and thermal ablations, are suggested alternatives. In this review, we evaluated the indications, devices, techniques, clinical outcomes, and complications associated with US-guided EA and thermal ablations based on available scientific evidence and expert opinions regarding the use of ablation for primary and recurrent thyroid cancers.
Results of RFA for micro-papillary cancers in 6 cases by J.Kim et al in a research article.
1.Size 0.6 1.3 cm
2. 36-64 month follow up.
3.98% decrease in size.
4. 4/6 complete ablation occurred.
5. 1/6 had only small resedual calcification no cancer cells.
6.1/6 absent cancer cells by FNA and cutting needle biopsy.
RFA for micro and macro papillary thyroid cancer
Jeong S.et al in research article
1. RFA was effective in macro and micro papillary thyroid cancers.
2. There was no use for RFA for rapidly growing anaplastic thyroid cancers.
Patient with large 8 cm cystic papillary who was not a candidate for surgery
After first RFA and cyst drainage the size was decreased to 2.4 cm
After second RFA the size was 1.9 cm
After 18 months a smaller ill defined 1.4 cm ablation zone.
and with decreased calcification.
Call me for details for RFA therapy for micro and macro papillary thyroid cancers.
The macro papillary must be in only in patients who are not candidates for thyroid surgery.
The micro-papillary cancers have refused surgery and active surveillance, or have dropped out of active surveillance but still did not want surgery.
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Richard Guttler MD,FACE,ECNU