Inoperable Symptomatic Recurrent Thyroid Cancers: Preliminary Result of Radiofrequency Ablation
- Thyroid RFA is usually for benign thyroid nodules and small primary micro-papillary thyroid cancers.
- However, it is also used for recurrent neck lymph node disease after modified radical neck dissection.
- Now we are using RFA for patients who are not a candidate for surgery with symptomatic disease.
- Symptoms included dysphagia, hoarseness, dyspnea, or a protruding mass due to recurrent tumors.
- 16 patients entered this study.
- The mean tumor volume and diameter were 9 ml (range 0.1–34 ml) and 2.9 cm (range 0.7–4.8 cm), respectively.
- 6/16 had complete ablation. 9/16 incomplete ablation. 1/16 failed ablation.
- Mean volume reduction was 50%
- 13/16 had reduction in volumes.
- 2/16 had regrowth.
- 7/16 had gains in relief of symptoms.
- 6 with large masses had gains in symptoms relief.
- One with tracheal compression symptoms improved.
- 1/16 had a skin burn, but no serious complications were seen.
- Short term relief for symptoms when surgery was not a possible option was a good thing for the patient.
- RFA is a good alternative to treat patients with inoperable thyroid cancer when used to treat troublesome symptoms.
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- Jung Hee Shin MD, PhD, et al
To determine the role of radiofrequency ablation (RFA) in patients with inoperable symptomatic recurrent thyroid cancers.
Materials and Methods
Eleven patients with 16 symptomatic recurrent thyroid cancers but ineligible for surgery were prospectively enrolled and underwent ultrasound-guided RFA with local anesthesia in 16 sessions. The mean tumor volume and diameter were 9 ml (range 0.1–34 ml) and 2.9 cm (range 0.7–4.8 cm), respectively. Patients had dysphagia, hoarseness, dyspnea, or a protruding mass due to recurrent tumors. Tumor volume was calculated from follow-up ultrasound, and symptoms were assessed after RFA.
Of 16 sessions, tumor ablation was complete in 6, incomplete in 9, and failed in 1. Incomplete or failed ablation was due to intolerable pain, severe calcified lesion, or tumor encasement of major vessels. Of 15 treated lesions, 13 decreased in volume. Regrowth of treated tumors was observed in 2 lesions. The mean volume reduction was 50.9% (range −9.4 to 96.8%). There were gains for symptom relief for 7 patients (63.6%) with protruding masses (n = 6) and discomfort due to tracheal compression (n = 1). The mean follow-up was 6 months (1–14 months). There were no major complications except a patient with skin burn.
RFA is feasible and safe, and can improve symptoms in the short term.