Ethanol Ablation for Thyroid Cancer 101:

Ethanol Ablation for Thyroid Cancer 101:

Ethanol Ablation for Thyroid Cancer 101:

Ethanol Ablation for Thyroid Cancer 101:

Dr.Guttler’s Comments:

  1. Advanced local disease stage iii and iv treated with ethanol ablation.
  2. 25 cases at the Mayo were treated with PEI.
  3. 35/37 biopsy proven cancer lymph node decreased in size after treatment.
  4. 17/37 were gone after therapy.
  5. 19 /22 patients without TG antibodies decreased their Thyroglobulin (86% )
  6. 83% of recurrences were handled by repeat PEI.
  7. No patients had lost their voice or died during the study.
  8. Neck dissection cost $40-50000.
  9. PE saved $1 million in hospital charges for a neck dissection in 25 patients.
  10. Cal me for evaluation of alternative ethanol treatment for recurrent thyroid cancer after radioiodine and neck dissections.
  11. 310-393-8860 or thyroid.manager@protonmail.com.
  12. Dr.G

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

Presented at the 34th Annual Meeting of the American Association of Endocrine Surgeons, Chicago, Illinois, April 14–16, 2013.

Background

Ultrasound-guided percutaneous ethanol ablation (UPEA) of neck nodal metastases (NNM) has rarely been reported in papillary thyroid carcinoma (PTC) patients with advanced localized disease.

Methods

We ablated 25 PTC patients with stage III or IVA disease (mean age 58 years) who had “recurrent” NNM after surgery and 131I therapy. Diagnosis of 37 selected NNM was proven by ultrasound-guided biopsy. UPEA was usually performed in 2 outpatient sessions.

Results

After UPEA, 35 of 37 NNM (95%) decreased in size. None had significant Doppler flow. Seventeen (46%) disappeared on rescanning. Serum thyroglobulin fell in 19 of 22 (86%) without thyroglobulin autoantibodies. None of the UPEA-treated NNM, followed on average for 5.4 years, required further intervention. Six patients (24%) subsequently developed 18 “new” recurrences. Of the 18, 15 (83%) were managed successfully by UPEA rather than operation. None of the 25 patients developed permanent hoarseness or have died from PTC. At our institution, where patients undergoing nodal dissections are charged $35–45,000, each outpatient UPEA procedure saves health providers approximately $38,400. Our 25 ablated patients, by avoiding 40 further neck reexplorations, on average, saved $61,440 in charges.

Conclusion

UPEA for NNM in advanced localized PTC has proved safe and effective. It is also considerably less expensive than the conventional operative alternative of nodal dissection.

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