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Radiofrequency Ablation to Treat Loco-Regional Recurrence of Well-Differentiated Thyroid Carcinoma

Korean Journal of Radiology 2014년 15권 6호 p.817 ~ p.826

이순진(Lee Sun-Jin) - Chung-Ang University Hospital Department of Radiology
정소령(Jung So-Lyung) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
김범수(Kim Bum-Soo) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
안국진(Ahn Kook-Jin) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
최현석(Choi Hyun-Seok) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
임동준(Lim Dong-Jun) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
김민희(Kim Min-Hee) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
배자성(Bae Ja-Seong) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
김민식(Kim Min-Sik) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Otolaryngology
정찬권(Jung Chan-Kwon) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Pathology
정세민(Chong Se-Min) - Chung-Ang University Hospital Department of Radiology

Abstract

Objective: To evaluate the efficacy of radiofrequency ablation (RFA) in the treatment of loco-regional, recurrent, and well-differentiated thyroid carcinoma.

Materials and Methods: Thirty-five recurrent well-differentiated thyroid carcinomas (RTC) in 32 patients were treated with RFA, between March 2008 and October 2011. RTCs were detected by regular follow-up ultrasound and confirmed by biopsy. All patients had fewer than 3 RTCs in the neck and were at high surgical risk or refused to undergo repeated surgery. Average number of RFA sessions were 1.3 (range 1-3). Post-RFA biopsy and ultrasound were performed. The mean follow-up period was 30 months. Pre- and post-RFA serum thyroglobulin values were evaluated.

Results: Thirty-one patients with 33 RTCs were treated with RFA only, whereas 1 patient with 2 RTCs was treated with RFA followed by surgery. At the last follow-up ultrasound, 31 (94%) of the 33 RTCs treated with RFA alone completely disappeared and the remaining 2 (6%) RTCs showed decreased volume. The largest diameter and volume of the 33 RTCs were markedly decreased by 93.2% (from 8.1 ± 3.4 mm to 0.6 ± 1.8 mm, p < 0.001) and 96.4% (from 173.9 ± 198.7 mm3 to 6.2 ± 27.9 mm3,p < 0.001), respectively. Twenty of the 21 RTCs evaluated with post-RFA biopsies (95%) were negative for malignancy. One (5%) showed remaining tumor that was removed surgically. The serum thyroglobulin was decreased in 19 of 26 patients (73%). Voice change developed immediately after RFA in 6 patients (19%) and was spontaneously recovered in 5 patients (83%).

Conclusion: Radiofrequency ablation can be effective in treating loco-regional, recurrent, and well-differentiated thyroid carcinoma in patients at high surgical risk.