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Efficacy and safety of percutaneous ultrasound guided radiofrequency ablation for treating cervical metastatic lymph nodes from papillary thyroid carcinoma.

Abstract：

PURPOSE:The aim of this study was to assess the effectiveness and safety of ultrasound guided percutaneous radiofrequency ablation (RFA) of cervical metastatic lymph nodes (LNs) from papillary thyroid carcinoma. METHODS:54 metastatic LNs confirmed by percutaneous biopsy in 33 patients with previous total thyroidectomy and radioiodine therapy were enrolled in this retrospective study. US and contrast-enhanced ultrasound (CEUS) examinations were performed before ablation. Follow-up consisted of conventional US, CEUS, thyroglobulin (Tg) level at 1, 3, 6, and 12 months and every 6 months thereafter. In 3 months after ablation, US-guided core needle biopsy (CNB) was performed in the center, at the edge of the ablation area to exclude recurrence. RESULTS:Technical success was obtained in all 54 lymph nodes (100%) without immediate or later major complications occurred. With a mean follow-up of 21 ± 4 months (range 12-24 months), there were no evidence of recurrence at ablated sites. After RFA, 33 metastatic LNs completely disappeared (33/54, 61.1%) and 21 metastatic lymph nodes remained as small scarlike lesions (21/54, 38.9%) at the last follow-up visit. The mean volume reduction ratio (VRR) was 32.7 ± 8.6% (range 21.2-59.3%), 46.8 ± 9.7% (range 33.6-68.1%), 62.5 ± 12.1% (range 42.5-95.4%), 77.1 ± 10.6% (range 54.3-100.0%), 89.2 ± 8.3% (range 68.7-100.0%) and 94.9 ± 5.3% (range 78.2-100.0%) at 1, 3, 6, 12, 18 and 24 months after RFA respectively. Significant differences in the VRR were found between every two follow-up visits (P < 0.001). At the last follow-up visit, the mean serum Tg level decreased from 10.2 ± 5.1 ng/ml (range 0.8-16.2 ng/ml) to 1.1 ± 0.8 ng/ml (range 0.2-3.1 ng/ml) (P < 0.001). CONCLUSIONS:Ultrasound guided percutaneous RFA for cervical metastatic LNs from papillary thyroid carcinoma is a feasible, effective and safe therapy. This procedure shows a nonsurgical therapeutic option that can eradicate the lesions with a very low complication rate.

journal_name

J Cancer Res Clin Oncol

journal_title

Journal of cancer research and clinical oncology

authors

Guang Y,Luo Y,Zhang Y,Zhang M,Li N,Zhang Y,Tang J

doi

10.1007/s00432-017-2386-6

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

1555-1562

issue

eissn

0171-5216

issn

1432-1335

pii

10.1007/s00432-017-2386-6

journal_volume

143

pub_type

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Efficacy and safety of percutaneous ultrasound guided radiofrequency ablation for treating cervical metastatic lymph nodes from papillary thyroid carcinoma.