Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Oncology Reports
Published in: Current Oncology Reports 8/2022

06-04-2022 | Metastasis | Interventional Oncology (DC Madoff, Section Editor)

Thermal Ablation for the Management of Papillary Thyroid Microcarcinoma in the Era of Active Surveillance and Hemithyroidectomy

Authors: Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Jeong Hyun Lee

Published in: Current Oncology Reports | Issue 8/2022

Login to get access

Abstract

Purpose of Review

Thermal ablation presents a therapeutic option other than active surveillance and immediate surgery for patients with low-risk papillary thyroid microcarcinomas (PTMC). Here, we have reviewed the current oncologic outcome of thermal ablation in PTMC cases and compared it with active surveillance and surgery.

Recent Findings

Thermal ablation in PTMC cases revealed no tumor progression for pooled 5-year follow-up data. This oncologic outcome of thermal ablation was comparable to that of immediate surgery with less morbidity. Additionally, no patient who underwent thermal ablation received delayed surgery during the follow-up period due to anxiety. However, active surveillance has indicated that a substantial proportion (range, 8–32%) of patients underwent surgery mainly due to anxiety.

Summary

In a subset of PTMC patients who are high-risk surgical candidates or who refuse surgery, especially those who have failed or are reluctant to pursue active surveillance, thermal ablation can be a good option.
Literature
1.
Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006;295(18):2164–7.PubMedCrossRef
2.
Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140(4):317–22.PubMedCrossRef
3.
Ahn HS, Kim HJ, Welch HG. Korea’s thyroid-cancer “epidemic”–screening and overdiagnosis. N Engl J Med. 2014;371(19):1765–7.PubMedCrossRef
4.
Vaccarella S, Franceschi S, Bray F, Wild CP, Plummer M, Dal Maso L. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N Engl J Med. 2016;375(7):614–7.PubMedCrossRef
5.
Ito Y, Uruno T, Nakano K, Takamura Y, Miya A, Kobayashi K, et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid: Off J Am Thyroid Assoc. 2003;13(4):381–7.CrossRef
6.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 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: Off J Am Thyroid Assoc. 2016;26(1):1–133.CrossRef
7.••
Cho SJ, Suh CH, Baek JH, Chung SR, Choi YJ, Chung KW, et al. Active surveillance for small papillary thyroid cancer: a systematic review and meta-analysis. Thyroid: Off J Am Thyroid Assoc. 2019;29(10):1399–408. This meta-analysis evaluates the oncologic outcome and the reason for delayed surgery of low-risk PTMC under active surveillance.CrossRef
8.
Sugitani I, Toda K, Yamada K, Yamamoto N, Ikenaga M, Fujimoto Y. Three distinctly different kinds of papillary thyroid microcarcinoma should be recognized: our treatment strategies and outcomes. World J Surg. 2010;34(6):1222–31.PubMedCrossRef
9.
Ito Y, Miyauchi A, Inoue H, Fukushima M, Kihara M, Higashiyama T, et al. An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg. 2009;34(1):28.CrossRef
10.
Jeon MJ, Lee YM, Sung TY, Han M, Shin YW, Kim WG, et al. Quality of life in patients with papillary thyroid microcarcinoma managed by active surveillance or lobectomy: a cross-sectional study. Thyroid: Off J Am Thyroid Assoc. 2019;29(7):956–62.CrossRef
11.
Davies L, Roman BR, Fukushima M, Ito Y, Miyauchi A. Patient experience of thyroid cancer active surveillance in Japan. JAMA Otolaryngol Head Neck Surg. 2019;145(4):363–70.PubMedPubMedCentralCrossRef
12.
Ito Y, Miyauchi A, Kihara M, Higashiyama T, Kobayashi K, Miya A. Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid: Off J Am Thyroid Assoc. 2014;24(1):27–34.CrossRef
13.
Kwon H, Oh HS, Kim M, Park S, Jeon MJ, Kim WG, et al. Active surveillance for patients with papillary thyroid microcarcinoma: a single center’s experience in Korea. J Clin Endocrinol Metab. 2017;102(6):1917–25.PubMedCrossRef
14.
Jensen CB, Saucke MC, Pitt SC. Active surveillance for thyroid cancer: a qualitative study of barriers and facilitators to implementation. BMC Cancer. 2021;21(1):471.PubMedPubMedCentralCrossRef
15.
Li J, Liu Y, Liu J, Yang P, Hu X, Qian L. A comparative study of short-term efficacy and safety for thyroid micropapillary carcinoma patients after microwave ablation or surgery. Int J Hyperthermia: Off J Eur Soc Hyperthermic Oncol N Am Hyperthermia Group. 2019;36(1):640–6.
16.
Cho SJ, Baek JH, Chung SR, Choi YJ, Lee JH. Long-term results of thermal ablation of benign thyroid nodules: a systematic review and meta-analysis. Endocrinol Metab. 2020;35(2):339–50.CrossRef
17.
Bernardi S, Giudici F, Cesareo R, Antonelli G, Cavallaro M, Deandrea M, et al. Five-year results of radiofrequency and laser ablation of benign thyroid nodules: a multicenter study from the Italian minimally invasive treatments of the thyroid group. Thyroid: Off J Am Thyroid Assoc. 2020;30(12):1759–70.CrossRef
18.
Chung S, Baek J, Choi YJ, Lee JH. Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. Eur Radiol. 2019;29:4897–903.
19.
Kim J-H, Baek JH, Lim HK, Ahn HS, Baek SM, Choi YJ, et al. 2017 Thyroid radiofrequency ablation guideline: Korean society of thyroid radiology. Korean J Radiol. 2018;19(4):632–55.PubMedPubMedCentralCrossRef
20.
Garberoglio R, Aliberti C, Appetecchia M, Attard M, Boccuzzi G, Boraso F, et al. Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement. J Ultrasound. 2015;18(4):423–30.PubMedPubMedCentralCrossRef
21.
Mauri G, Hegedüs L, Bandula S, Cazzato RL, Czarniecka A, Dudeck O, et al. European thyroid association and cardiovascular and interventional radiological society of Europe 2021 clinical practice guideline for the use of minimally invasive treatments in malignant thyroid lesions. Eur Thyroid J. 2021;10(3):185–97.PubMedPubMedCentralCrossRef
22.••
Cho SJ, Baek SM, Na DG, Lee KD, Shong YK, Baek JH. Five-year follow-up results of thermal ablation for low-risk papillary thyroid microcarcinomas: systematic review and meta-analysis. Eur Radiol. 2021;31(9):6446–6456. This meta-analysis evaluates the 5-year follow-up oncologic outcome and safety of thermal abation for low-risk PTMC.
23.•
Zhang M, Tufano RP, Russell JO, Zhang Y, Zhang Y, Qiao Z, et al. Ultrasound-guided radiofrequency ablation versus surgery for low-risk papillary thyroid microcarcinoma: results of over 5 years’ follow-up. Thyroid: Off J Am Thyroid Assoc. 2020;30(3):408–17. This study demonstrated the 5-year comparable data for patients who underwent RFA and surgery for PTMC.CrossRef
24.•
Teng D-K, Li W-H, Du J-R, Wang H, Yang D-Y, Wu X-L. Effects of microwave ablation on papillary thyroid microcarcinoma: a five-year follow-up report. Thyroid: Off J Am Thyroid Assoc. 2020;30(12):1752–8. This study demonstrated the first 5-year follow-up data for patients who underwent microwave ablation for PTMC.CrossRef
25.•
Cho SJ, Baek SM, Lim HK, Lee KD, Son JM, Baek JH. Long-term follow-up results of ultrasound-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma: more than 5-year follow-up for 84 tumors. Thyroid. 2020;30(12):1745–51. This study demonstrated the first 5-year follow-up data for patients who underwent RFA for PTMC.
26.
Xu B, Zhou NM, Cao WT, Gu SY. Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma. World J Clin Cases. 2018;6(15):936–43.PubMedPubMedCentralCrossRef
27.
Zhou W, Ni X, Xu S, Zhang L, Chen Y, Zhan W. Ultrasound-guided laser ablation versus surgery for solitary papillary thyroid microcarcinoma: a retrospective study. Int J Hyperthermia: Off J Eur Soc Hyperthermic Oncol N Am Hyperthermia Group. 2019;36(1):897–904.
28.••
Kim HJ, Cho SJ, Baek JH. Comparison of thermal ablation and surgery for low-risk papillary thyroid microcarcinoma: a systematic review and meta-analysis. Korean J Radiol. 2021;22:1730–41. This meta-analysis compares the oncologic outcome and safety of thermal abation and surgery for low-risk PTMC.PubMedPubMedCentralCrossRef
29.••
Mauri G, Gennaro N, Lee MK, Baek JH. Laser and radiofrequency ablations for benign and malignant thyroid tumors. Int J Hyperthermia. 2019;36(2):13–20. This study is a comprehensive review of thermal ablation for benign and malignant thyroid nodules.
30.
Ma B, Wei W, Xu W, Wang Y, Guan H, Fan J, et al. Surgical confirmation of incomplete treatment for primary papillary thyroid carcinoma by percutaneous thermal ablation: a retrospective case review and literature review. Thyroid: Off J Am Thyroid Assoc. 2018;28(9):1134–42.CrossRef
31.
32.
Shin JE, Baek JH, Lee JH. Radiofrequency and ethanol ablation for the treatment of recurrent thyroid cancers: current status and challenges. Curr Opin Oncol. 2013;25(1):14–9.PubMedCrossRef
33.
Baek JH, Lee JH, Sung JY, Bae JI, Kim KT, Sim J, et al. Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology. 2012;262(1):335–42.PubMedCrossRef
34.
Laeseke PF, Sampson LA, Brace CL, Winter TC 3rd, Fine JP, Lee FT Jr. Unintended thermal injuries from radiofrequency ablation: protection with 5% dextrose in water. AJR Am J Roentgenol. 2006;186(5 Suppl):S249–54.PubMedCrossRef
35.
Chung SR, Suh CH, Baek JH, Park HS, Choi YJ, Lee JH. Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperthermia. 2017;33(8):920–30.
36.
Jung SL, Baek JH, Lee JH, Shong YK, Sung JY, Kim KS, et al. Efficacy and safety of radiofrequency ablation for benign thyroid nodules: a prospective multicenter study. Korean J Radiol. 2018;19(1):167–74.PubMedPubMedCentralCrossRef
37.
Wang JF, Wu T, Hu KP, Xu W, Zheng BW, Tong G, et al. Complications following radiofrequency ablation of benign thyroid nodules: a systematic review. Chin Med J. 2017;130(11):1361–70.PubMedPubMedCentralCrossRef
38.
Kim C, Lee JH, Choi YJ, Kim WB, Sung TY, Baek JH. Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers. Eur Radiol. 2017;27(8):3128–37.PubMedCrossRef
39.•
Chung SR, Baek JH, Choi YJ, Lee JH. Management strategy for nerve damage during radiofrequency ablation of thyroid nodules. Int J Hyperthermia. 2019;36(1):204–10. In this study, the effect of cold dextrose solution injection on nerve damage occurred during thermal ablation was studied, and management methods were presented when nerve damage occurred during thermal ablation.
40.
Lee MK, Baek JH, Chung SR, Choi YJ, Lee Y-M, Kim TY, et al. Effectiveness of injecting cold 5% dextrose into patients with nerve damage symptoms during thyroid radiofrequency ablation. Endocrinol Metab (Seoul). 2020;35(2):407–15.CrossRef
41.
Hughes DT, White ML, Miller BS, Gauger PG, Burney RE, Doherty GM. Influence of prophylactic central lymph node dissection on postoperative thyroglobulin levels and radioiodine treatment in papillary thyroid cancer. Surgery. 2010;148(6):1100–6 (discussion 006-7).PubMedCrossRef
42.
Chisholm EJ, Kulinskaya E, Tolley NS. Systematic review and meta-analysis of the adverse effects of thyroidectomy combined with central neck dissection as compared with thyroidectomy alone. Laryngoscope. 2009;119(6):1135–9.PubMedCrossRef
43.
Viola D, Materazzi G, Valerio L, Molinaro E, Agate L, Faviana P, et al. Prophylactic central compartment lymph node dissection in papillary thyroid carcinoma: clinical implications derived from the first prospective randomized controlled single institution study. J Clin Endocrinol Metab. 2015;100(4):1316–24.PubMedCrossRef
44.
Suh CH, Baek JH, Choi YJ, Lee JH. Performance of CT in the preoperative diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2017;38(1):154–61.PubMedPubMedCentralCrossRef
45.
Kim H, Ryu W, Woo SU, Son G, Lee E, Lee J, et al. Primary papillary thyroid carcinoma previously treated incompletely with radiofrequency ablation. J Cancer Res Ther. 2010;6:310–2.PubMedCrossRef
46.
Ji L, Wu Q, Gu J, Deng X, Zhou W, Fan X, et al. Ultrasound-guided percutaneous laser ablation for papillary thyroid microcarcinoma: a retrospective analysis of 37 patients. Cancer Imaging. 2019;19(1):16.PubMedPubMedCentralCrossRef
47.
Kim JH, Baek JH, Sung JY, Min HS, Kim KW, Hah JH, et al. Radiofrequency ablation of low-risk small papillary thyroidcarcinoma: preliminary results for patients ineligible for surgery. Int J Hyperthermia. 2017;33(2):212–9.
48.
Li J, Liu Y, Liu J, Qian L. Ultrasound-guided percutaneous microwave ablation versus surgery for papillary thyroid microcarcinoma. Int J Hyperthermia: Off J Eur Soc Hyperthermic Oncol N Am Hyperthermia Group. 2018;34(5):653–9.CrossRef
49.
Lim HK, Cho SJ, Baek JH, Lee KD, Son CW, Son JM, et al. US-guided radiofrequency ablation for low-risk papillary thyroid microcarcinoma: efficacy and safety in a large population. Korean J Radiol. 2019;20(12):1653–61.PubMedPubMedCentralCrossRef
50.
Teng DK, Li HQ, Sui GQ, Lin YQ, Luo Q, Fu P, et al. Preliminary report of microwave ablation for the primary papillary thyroid microcarcinoma: a large-cohort of 185 patients feasibility study. Endocrine. 2019;64(1):109–17.PubMedCrossRef
51.
Wu R, Luo Y, Tang J, Yang M, Li J, Zhang Y, et al. Ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma: a retrospective analysis of 198 patients. Int J Hyperthermia. 2020;37(1):168–74.
52.
Yue WW, Qi L, Wang DD, Yu SJ, Wang XJ, Xu HX, et al. US-guided microwave ablation of low-risk papillary thyroid microcarcinoma: longer-term results of a prospective study. J Clin Endocrinol Metab. 2020;105(6):dgaa128.PubMedCrossRef
53.
Zhang L, Zhou W, Zhan W, Peng Y, Jiang S, Xu S. Percutaneous laser ablation of unifocal papillary thyroid microcarcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in assessing local therapeutic response. World J Surg. 2018;42(8):2476–84.PubMedCrossRef
54.
Zhou W, Jiang S, Zhan W, Zhou J, Xu S, Zhang L. Ultrasound-guided percutaneous laser ablation of unifocal T1N0M0 papillary thyroid microcarcinoma: preliminary results. Eur Radiol. 2017;27(7):2934–40.PubMedCrossRef
Metadata
Title
Thermal Ablation for the Management of Papillary Thyroid Microcarcinoma in the Era of Active Surveillance and Hemithyroidectomy
Authors
Sae Rom Chung
Jung Hwan Baek
Young Jun Choi
Jeong Hyun Lee
Publication date
06-04-2022
Publisher
Springer US
Published in
Current Oncology Reports / Issue 8/2022
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-022-01268-2

Other articles of this Issue 8/2022

Current Oncology Reports 8/2022 Go to the issue

Leukemia (A Aguayo, Section Editor)

Controversies in the Treatment of Adolescents and Young Adults with Philadelphia Chromosome-Negative B-Cell Acute Lymphoblastic Leukemia

Interventional Oncology (DC Madoff, Section Editor)

Role of Image-Guided Percutaneous Needle Biopsy in the Age of Precision Medicine

Lymphomas (T Hilal, Section Editor)

Richter’s Transformation

Leukemia (A Aguayo, Section Editor)

Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

Pediatric Oncology (KL Davis, Section Editor)

Neuroblastoma Heterogeneity, Plasticity, and Emerging Therapies

Melanoma (DB Johnson, Section Editor)

Triplet Therapy in Melanoma — Combined BRAF/MEK Inhibitors and Anti-PD-(L)1 Antibodies
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits