PURPOSE: Small papillary thyroid carcinoma is a therapeutic dilemma in surgically ineligible patients and the effectiveness of radiofrequency ablation (RFA) in these patients has never been presented. The purpose of our study was to retrospectively evaluate the outcome of radiofrequency ablation in these patients.
MATERIALS AND METHODS: This study received approval from the institutional review board, and informed consent was waived. Between 2005 and 2009, 6 thyroid cancers (mean diameter, 0.85 cm, range, 0.6 –1.1 cm) in 6 patients (4 women, 2 men; mean age, 72 years; range, 64-79 years) were treated with RFA by 3 radiologists in 2 hospitals. The inclusion criteria for RFA were tumor confirmed with ultrasound-guidedfine-needle aspiration biopsy, no metastatic tumor anywhere, ineligibility for surgery, feasibility of RFA in terms of location and size, and at least 2-3 year follow-up after RFA. The medical records and images were reviewed and analyzed focusing on procedure profile of RFA, symptoms and complication during and after RFA, changes of the tumors on ultrasound and CT.
RESULTS: RFA was done using a radiofrequency generator and 18-gauge internally cooled electrodes with a 7-cm shaft length and 0.5-1 cm active tips. Five of the 6 tumors were ablated in a single session and 1 tumor required 2 sessions using 10-20 watt during 7 -15 minutes. Severe headache and hypertension (n=1) and mild neck pain (n=2) were developed during procedure and subsided. There was no major complication. During 2.9 year follow up (range, 2 – 4 years), 3 cancers (3/6, 50%) were completely disappeared, 2 cancers showed about 20% remaining lesions on ultrasound. The remaining 1 cancer showed purely calcified residual lesion with disappearance of surrounding solid portion of initial tumor on ultrasound.
CONCLUSION: Although surgery is the standard treatment of thyroid cancer, RFA is effective for control of small thyroid carcinoma without lymph node metastasis in patients for whom surgery is infeasible.
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SS 07 TH-07.pdf
