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Preliminary report of microwave ablation for the primary papillary thyroid microcarcinoma: a large-cohort of 185 patients feasibility study

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Abstract

Purpose

To assess the safety and efficacy of microwave ablation (MWA) for primary papillary thyroid microcarcinoma (PTMC) with a large sample of 185 patients.

Methods

A total of 185 patients underwent MWA for 206 primary PTMC nodules. They received ultrasound follow-up at 1, 3, 6, and 12 months after MWA and every 6 months thereafter. Nodule volumes were calculated at each follow-up and compared with those before MWA. Additionally, the volume reduction rate (VRR) of the nodules was calculated. Patients’ thyroid functions were tested before and 1 month after MWA.

Results

The mean follow-up time of the 185 patients was 20.7 ± 8.8 months (range 12–36 months). During the follow-up period, the mean volume of the 206 nodules was 100.1 ± 92.9 mm3 (range 3.6–423.9) before MWA, which decreased to 2.2 ± 5.6 mm3 (range 0–20.3 mm3) after MWA (P = 0.000). The mean VRR of the nodules was 98.65 ± 3.60% after MWA (range 83.85–100%). One hundred and seventy four of 206 nodules (84.5%) were fully absorbed. Compared with the preoperative results, no significant variation in thyroid function was observed 1 month after MWA. Thirty-eight patients (20.5%) had different types of complications, ranging from minor to major. Five patients (2.7%) had hoarseness, 11 patients (5.9%) had bleeding, 21 patients (11.4%) had earache or toothache, and one patient had another lesion 1 month after MWA.

Conclusions

This preliminary study suggests that MWA is safe and effective in the treatment of primary PTMC and offers a new alternative for clinical treatment.

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References

  1. L.G. Morris, R.M. Tuttle, L. Davies, Changing Trends in the Incidence of Thyroid Cancer in the United States. JAMA Otolaryngol.-- Head Neck Surg. 142(7), 709–711 (2016). https://doi.org/10.1001/jamaoto.2016.0230

    Article  PubMed  PubMed Central  Google Scholar 

  2. B. Aschebrook-Kilfoy, R.B. Schechter, Y.C. Shih, E.L. Kaplan, B.C. Chiu, P. Angelos, R.H. Grogan, The clinical and economic burden of a sustained increase in thyroid cancer incidence. Cancer Epidemiol. Biomark. Prev. 22(7), 1252–1259 (2013). https://doi.org/10.1158/1055-9965.epi-13-0242

    Article  Google Scholar 

  3. S. Vaccarella, S. Franceschi, F. Bray, C.P. Wild, M. Plummer, L. Dal Maso, Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N. Engl. J. Med. 375(7), 614–617 (2016). https://doi.org/10.1056/NEJMp1604412

    Article  PubMed  Google Scholar 

  4. Y. Ito, A. Miyauchi, H. Oda, Low-risk papillary microcarcinoma of the thyroid: A review of active surveillance trials. Eur. J. Surg. Oncol. (2017). https://doi.org/10.1016/j.ejso.2017.03.004

  5. A. Griffin, J.P. Brito, M. Bahl, J.K. Hoang, Applying criteria of active surveillance to low-risk papillary thyroid cancer over a decade: how many surgeries and complications can be avoided? Thyroid 27(4), 518–523 (2017). https://doi.org/10.1089/thy.2016.0568

    Article  CAS  PubMed  Google Scholar 

  6. G.C. Haser, R.M. Tuttle, H.K. Su, E.E. Alon, D. Bergman, V. Bernet, E. Brett, R. Cobin, E.H. Dewey, G. Doherty, L.L. Dos Reis, J. Harris, J. Klopper, S.L. Lee, R.A. Levine, S.J. Lepore, I. Likhterov, M.A. Lupo, J. Machac, J.I. Mechanick, S. Mehra, M. Milas, L.A. Orloff, G. Randolph, T.A. Revenson, K.J. Roberts, D.S. Ross, M.E. Rowe, R.C. Smallridge, D. Terris, R.P. Tufano, M.L. Urken, Active surveillance for papillary thyroid microcarcinoma: new challenges and opportunities for the health care system. Endocr. Pract. 22(5), 602–611 (2016). https://doi.org/10.4158/ep151065.ra

    Article  PubMed  PubMed Central  Google Scholar 

  7. H.G. Welch, G.M. Doherty, Saving thyroids - overtreatment of small papillary cancers. N. Engl. J. Med. 379(4), 310–312 (2018). https://doi.org/10.1056/NEJMp1804426

    Article  PubMed  Google Scholar 

  8. P. Liang, Y. Wang, X. Yu, B. Dong, Malignant liver tumors: treatment with percutaneous microwave ablation--complications among cohort of 1136 patients. Radiology 251(3), 933–940 (2009). https://doi.org/10.1148/radiol.2513081740

    Article  PubMed  Google Scholar 

  9. J. Yu, P. Liang, X.L. Yu, Z.G. Cheng, Z.Y. Han, X. Zhang, J. Dong, M.J. Mu, X. Li, X.H. Wang, US-guided percutaneous microwave ablation versus open radical nephrectomy for small renal cell carcinoma: intermediate-term results. Radiology 270(3), 880–887 (2014). https://doi.org/10.1148/radiol.13130275

    Article  PubMed  Google Scholar 

  10. L. Sidoff, D.E. Dupuy, Clinical experiences with microwave thermal ablation of lung malignancies. Int. J. Hyperth. 33(1), 25–33 (2017). https://doi.org/10.1080/02656736.2016.1204630

    Article  CAS  Google Scholar 

  11. J. Xu, H. Wu, Z. Han, J. Zhang, Q. Li, J. Dou, C. An, E. Qi, J. Yu, P. Liang, Microwave ablation of benign breast tumors: a prospective study with minimum 12 months follow-up. Int. J. Hyperth. 1–9 (2018). https://doi.org/10.1080/02656736.2018.1494340

  12. X. Zhi, N. Zhao, Y. Liu, J.B. Liu, C. Teng, L. Qian, Microwave ablation compared to thyroidectomy to treat benign thyroid nodules. Int. J. Hyperth. 34(5), 644–652 (2018). https://doi.org/10.1080/02656736.2018.1456677

    Article  Google Scholar 

  13. B.W. Zheng, J.F. Wang, J.X. Ju, T. Wu, G. Tong, J. Ren, Efficacy and safety of cooled and uncooled microwave ablation for the treatment of benign thyroid nodules: a systematic review and meta-analysis. Endocrine 62(2), 307–317 (2018). https://doi.org/10.1007/s12020-018-1693-2

    Article  CAS  PubMed  Google Scholar 

  14. Z. Cheng, Y. Che, S. Yu, S. Wang, D. Teng, H. Xu, J. Li, D. Sun, Z. Han, P. Liang, US-Guided Percutaneous Radiofrequency versus Microwave Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study. Sci. Rep. 7(1), 9554 (2017). https://doi.org/10.1038/s41598-017-09930-7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. A.P. Mainini, C. Monaco, L.C. Pescatori, C. De Angelis, F. Sardanelli, L.M. Sconfienza, G. Mauri, Image-guided thermal ablation of benign thyroid nodules. J. Ultrasound 20(1), 11–22 (2017). https://doi.org/10.1007/s40477-016-0221-6

    Article  PubMed  Google Scholar 

  16. W. Yue, S. Wang, S. Yu, B. Wang, Ultrasound-guided percutaneous microwave ablation of solitary T1N0M0 papillary thyroid microcarcinoma: initial experience. Int. J. Hyperth. 30(2), 150–157 (2014). https://doi.org/10.3109/02656736.2014.885590

    Article  Google Scholar 

  17. D. Teng, G. Sui, C. Liu, Y. Wang, Y. Xia, H. Wang, Long-term efficacy of ultrasound-guided low power microwave ablation for the treatment of primary papillary thyroid microcarcinoma: a 3-year follow-up study. J. Cancer Res. Clin. Oncol. 144(4), 771–779 (2018). https://doi.org/10.1007/s00432-018-2607-7

    Article  PubMed  Google Scholar 

  18. J. Li, Y. Liu, J. Liu, L. Qian, Ultrasound-guided percutaneous microwave ablation versus surgery for papillary thyroid microcarcinoma. Int. J. Hyperth. 34(5), 653–659 (2018). https://doi.org/10.1080/02656736.2018.1453092

    Article  Google Scholar 

  19. D. Teng, L. Ding, Y. Wang, C. Liu, Y. Xia, H. Wang, Safety and efficiency of ultrasound-guided low power microwave ablation in the treatment of cervical metastatic lymph node from papillary thyroid carcinoma: a mean of 32 months follow-up study. Endocrine 62(3), 648–654 (2018). https://doi.org/10.1007/s12020-018-1711-4

    Article  CAS  PubMed  Google Scholar 

  20. J.H. Kim, J.H. Baek, H.K. Lim, H.S. Ahn, S.M. Baek, Y.J. Choi, Y.J. Choi, S.R. Chung, E.J. Ha, S.Y. Hahn, S.L. Jung, D.S. Kim, S.J. Kim, Y.K. Kim, C.Y. Lee, J.H. Lee, K.H. Lee, Y.H. Lee, J.S. Park, H. Park, J.H. Shin, C.H. Suh, J.Y. Sung, J.S. Sim, I. Youn, M. Choi, D.G. Na, 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean J. Radiol. 19(4), 632–655 (2018). https://doi.org/10.3348/kjr.2018.19.4.632

    Article  PubMed  PubMed Central  Google Scholar 

  21. Y. Guang, Y. Luo, Y. Zhang, M. Zhang, N. Li, Y. Zhang, J. Tang, Efficacy and safety of percutaneous ultrasound guided radiofrequency ablation for treating cervical metastatic lymph nodes from papillary thyroid carcinoma. J. Cancer Res. Clin. Oncol. 143(8), 1555–1562 (2017). https://doi.org/10.1007/s00432-017-2386-6

    Article  CAS  PubMed  Google Scholar 

  22. G. Mauri, L. Cova, T. Ierace, A. Baroli, E. Di Mauro, C.M. Pacella, S.N. Goldberg, L. Solbiati, Treatment of metastatic lymph nodes in the neck from papillary thyroid carcinoma with percutaneous laser ablation. Cardiovasc. Interv. Radiol. 39(7), 1023–1030 (2016). https://doi.org/10.1007/s00270-016-1313-6

    Article  Google Scholar 

  23. W. Zhou, S. Jiang, W. Zhan, J. Zhou, S. Xu, L. Zhang, Ultrasound-guided percutaneous laser ablation of unifocal T1N0M0 papillary thyroid microcarcinoma: preliminary results. Eur. Radiol. 27(7), 2934–2940 (2017). https://doi.org/10.1007/s00330-016-4610-1

    Article  PubMed  Google Scholar 

  24. L. Zhang, W. Zhou, W. Zhan, Y. Peng, S. Jiang, S. Xu, Percutaneous laser ablation of unifocal papillary thyroid microcarcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in assessing local therapeutic response. World J. Surg. 42(8), 2476–2484 (2018). https://doi.org/10.1007/s00268-018-4500-6

    Article  PubMed  Google Scholar 

  25. R. Valcavi, S. Piana, G.S. Bortolan, R. Lai, V. Barbieri, R. Negro, Ultrasound-guided percutaneous laser ablation of papillary thyroid microcarcinoma: a feasibility study on three cases with pathological and immunohistochemical evaluation. Thyroid 23(12), 1578–1582 (2013). https://doi.org/10.1089/thy.2013.0279

    Article  PubMed  Google Scholar 

  26. E. Papini, R. Guglielmi, H. Gharib, I. Misischi, F. Graziano, M. Chianelli, A. Crescenzi, A. Bianchini, D. Valle, G. Bizzarri, Ultrasound-guided laser ablation of incidental papillary thyroid microcarcinoma: a potential therapeutic approach in patients at surgical risk. Thyroid 21(8), 917–920 (2011). https://doi.org/10.1089/thy.2010.0447

    Article  PubMed  PubMed Central  Google Scholar 

  27. J.H. Kim, J.H. Baek, J.Y. Sung, H.S. Min, K.W. Kim, J.H. Hah, D.J. Park, K.H. Kim, B.Y. Cho, D.G. Na, Radiofrequency ablation of low-risk small papillary thyroidcarcinoma: preliminary results for patients ineligible for surgery. Int. J. Hyperth., 1–11 (2016). https://doi.org/10.1080/02656736.2016.1230893

  28. M. Zhang, Y. Luo, Y. Zhang, J. Tang, Efficacy and safety of ultrasound-guided radiofrequency ablation for treating low-risk papillary thyroid microcarcinoma: a prospective study. Thyroid 26(11), 1581–1587 (2016). https://doi.org/10.1089/thy.2015.0471

    Article  PubMed  Google Scholar 

  29. D.G. Na, J.H. Lee, S.L. Jung, J.H. Kim, J.Y. Sung, J.H. Shin, E.K. Kim, J.H. Lee, D.W. Kim, J.S. Park, K.S. Kim, S.M. Baek, Y. Lee, S. Chong, J.S. Sim, J.Y. Huh, J.I. Bae, K.T. Kim, S.Y. Han, M.Y. Bae, Y.S. Kim, J.H. Baek, Radiofrequency ablation of benign Thyroid nodules and recurrent Thyroid cancers: Consensus statement and recommendations. Kor. J. Radiol. 13(2), 117–125 (2012). https://doi.org/10.3348/kjr.2012.13.2.117

    Article  Google Scholar 

  30. B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M. Sawka, M. Schlumberger, K.G. Schuff, S.I. Sherman, J.A. Sosa, D.L. Steward, R.M. Tuttle, L. Wartofsky, 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26(1), 1–133 (2016). https://doi.org/10.1089/thy.2015.0020

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This study was funded by the Finance Department of Jilin Province (No. SCZSY201701), the Jilin Provincial Health and Family Planning Commission (NO. 2016ZC032) and Jilin Province Science and Technology Department (NO. 20170414042GH).

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  1. These authors contributed equally: Deng-Ke Teng, He-Qun Li

Authors and Affiliations

  1. Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, China

    Deng-Ke Teng, He-Qun Li, Guo-Qing Sui, Yuan-Qiang Lin, Qiang Luo, Ping Fu, Jia-Rui Du, Chun-Xiang Jin & Hui Wang

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Teng, DK., Li, HQ., Sui, GQ. et al. Preliminary report of microwave ablation for the primary papillary thyroid microcarcinoma: a large-cohort of 185 patients feasibility study. Endocrine 64, 109–117 (2019). https://doi.org/10.1007/s12020-019-01868-2

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