Radiofrequency ablation bests surgery for small thyroid tumors
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Adults with papillary thyroid microcarcinoma may spend less time and money without sacrificing treatment benefits if they have radiofrequency ablation rather than thyroid surgery, according to findings published in Thyroid.
“For carefully selected papillary thyroid microcarcinoma, radiofrequency ablation did not have inferior oncologic outcomes after 5 years of follow-up when compared with open surgery in this study. Complications and costs were lower and quality of life was better,” Yukun Luo, MD, of the department of ultrasound at The First Medical Center of the General Hospital of Chinese PLA in Beijing, and colleagues wrote. “Longer follow-up and additional studies with more patients will be necessary to demonstrate whether these findings are durable or reproducible.”
Luo and colleagues assessed the results of papillary thyroid microcarcinoma treatments for 94 adults who had radiofrequency ablation (mean age, 45.4 years; 74.5% women) and 80 who had a lobectomy or thyroidectomy (mean age, 44.1 years; 75% women). The researchers identified changes in tumor size and volume with ultrasound every 6 months for 5 years; medical records revealed length, cost and amount of blood loss for procedures. At 5 years posttreatment, participants completed the Thyroid Cancer-specific Quality of Life questionnaire.
There was no difference in mean tumor diameter or tumor volume between the radiofrequency ablation and surgery groups.
“Our results demonstrate that radiofrequency ablation was not inferior to surgery with respect to oncologic efficacy after 5 years,” the researchers wrote. “This may, in part, be the indolent nature of papillary thyroid microcarcinoma, with very low rates of recurrent, persistent or distant disease, regardless of treatment strategy.”
Radiofrequency ablation lasted 7.99 minutes on average, and thyroid surgery lasted 62.9 minutes on average (P < .001). In addition, those who had radiofrequency ablation did not require hospitalization, but those who had surgery spent 9.35 days on average in the hospital (P < .001). Similarly, those who had radiofrequency ablation did not lose any blood during treatment, but those who had surgery lost 26.1 mL on average (P < .001). The cost of radiofrequency ablation was $1,832 on average compared with an average cost of $2,355 for surgery (P < .001).
The average score on the quality of life assessment was 13.1 for those who had radiofrequency ablation vs. 14.7 for those who had surgery, which “showed that the surgery group had a lower thyroid-related quality of life.”
“Patients in the surgery group received [thyrotropin] suppression therapy. Patients in the radiofrequency ablation group did not receive any treatment with levothyroxine,” the researchers wrote. “It is likely that this difference affects the thyroid-related quality of life scores to some degree, and it may even affect tumor progression or recurrence as we continue to follow this cohort in future years.” – by Phil Neuffer
Disclosures: Luo reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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