Percutaneous ablation of low-risk papillary thyroid cancer.
R Michael TuttleDuan LiFourat RidouaniPublished in: Endocrine-related cancer (2023)
Minimalistic management options such as active surveillance and thyroid lobectomy are increasingly being accepted as reasonable management options for properly selected patients with low-risk papillary thyroid cancer. Leveraging technologies developed for the treatment of benign thyroid nodules, ultrasound-guided percutaneous thermal ablation is now being evaluated as a potential additional minimalistic management option for small, intrathyroidal, low-risk papillary thyroid cancer. Published retrospective data on more than 5000 low-risk papillary thyroid cancer patients treated with thermal ablation indicate that with appropriate training and proper patient selection, these technologies can be safely and effectively applied to papillary microcarcinomas. When compared to immediate surgery, thermal ablation appears to have lower complication rates with similar short-term rates of recurrence. Proper patient selection is facilitated by the use of a clinical framework which integrates imaging characteristics, patient characteristics, and medical team characteristics to classify a patient as ideal, appropriate, or inappropriate for minimalistic management options (active surveillance, thyroid lobectomy, or thermal ablation). While retrospective in nature and lacking randomized prospective clinical trial data, currently available data do support the proposition that thermal ablation technologies reliably destroy papillary thyroid microcarcinoma lesions and are associated with clinically acceptable oncologic outcomes when done by experienced teams in properly selected patients.
Keyphrases
- papillary thyroid
- lymph node metastasis
- radiofrequency ablation
- ultrasound guided
- case report
- clinical trial
- minimally invasive
- catheter ablation
- big data
- clear cell
- healthcare
- squamous cell carcinoma
- high resolution
- open label
- newly diagnosed
- randomized controlled trial
- machine learning
- atrial fibrillation
- palliative care
- climate change
- chronic kidney disease
- systematic review
- young adults
- data analysis
- percutaneous coronary intervention
- study protocol
- fluorescence imaging