Radiofrequency ablation eliminates tumor for most adults with low-risk thyroid cancer
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Key takeaways:
- Radiofrequency ablation had a technical efficacy of 96.1% for adults with low-risk thyroid cancer.
- Tumor disappearance occurred for 91.6% of participants during follow-up.
More than 95% of adults with low-risk papillary thyroid cancer were disease-free after radiofrequency ablation, according to findings from a single-center study published in Thyroid.
“Ultrasound-guided radiofrequency ablation is effective for treating of small unifocal low-risk papillary thyroid cancer, with 96.1% technical efficacy by core-needle biopsy pathological examination and 91.6% tumor disappearance rate on ultrasound,” Yukon Luo, MD, director of the department of ultrasound, and Mingbo Zhang, MD, associate chief physician in the department of ultrasound at First Medical Center of Chinese People’s Liberation Army General Hospital in Beijing, and colleagues wrote. “Importantly, a complete ablation of low-risk papillary thyroid cancer can be reliably obtained in tumors up to 10 mm, while persistent disease may be detected after treatment of tumors > 10 mm in 12.2% of cases.”
Researchers conducted a retrospective study with 382 adults with unifocal low-risk papillary thyroid cancer who underwent radiofrequency ablation from May 2014 to August 2021 (mean age, 43.1 years). Ultrasound, CT scan, laboratory tests and a pathology examination took place before radiofrequency ablation. After radiofrequency ablation, follow-up was conducted using ultrasound at 1, 3, 6 and 12 months, and then every 6 to 12 months thereafter. Technique efficacy, which was defined as the complete ablation of the tumor, was the primary endpoint of the study. Secondary endpoints included technical success, which was defined as complete coverage of the target tumor by the ablation zone on ultrasound at the end of each procedure, tumor disappearance and tumor volume reduction ratio.
During a mean follow-up of 67.8 months, the technical efficacy of radiofrequency ablation was 96.1%, with the remaining 3.9% of participants having persistent disease. The rate of persistent disease was 2.9% for adults with a tumor diameter of 10 mm or smaller and 12.2% for those with a tumor of more than 10 mm in diameter. No distant metastases were observed during the study.
In multivariable analysis, larger tumor size was associated with a greater likelihood for persistent disease (adjusted OR = 3.56; 95% CI, 1.12-11.3; P = .03) and adults with a subcapsular tumor location were less likely to have persistent disease (aOR = 0.29; 95% CI, 0.09-0.94; P = .04).
Technical success of radiofrequency ablation was 100%. Median volume of the ablation zone decreased by 62.1% at 6 months, 98% at 12 months and 100% at 18 months. Of the 367 ablation zones with benign results on core-needle biopsy, 91.6% had tumor disappearance during follow-up. Tumor disappearance occurred a mean 15.4 months after radiofrequency ablation. Of tumors with scarring, 76.8% had scarring completely disappear by the final follow-up.
“Technical efficacy should be defined as the complete ablation of the target tumor, including tumor disappearance by imaging follow-up together with the pathologically confirmed absence of tumor cells in the ablation zone,” the researchers wrote. “This recommendation can ensure an objective and reliable interpretation of the complete tumor response after radiofrequency ablation of papillary thyroid cancer and standardize the techniques and outcomes of radiofrequency ablation as a treatment option.”
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