Chung, Sae Rom; Baek, Jung Hwan; Choi, Young Jun; Sung, Tae-Yon; Song, Dong Eun; Kim, Tae Yong; Lee, Jeong Hyun
European radiology
2020Sep ; 12 ( 4 ) :.
PMID : 32945966
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Chung, Sae Rom - Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-gu, Seoul, 05505, South Korea.
Baek, Jung Hwan - Department of Radiology and Research Institute of Radiology, University of Ulsan
Choi, Young Jun - Department of Radiology and Research Institute of Radiology, University of Ulsan
Sung, Tae-Yon - Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center,
Song, Dong Eun - Department of Pathology, University of Ulsan College of Medicine, Asan Medical
Kim, Tae Yong - Department of Endocrinology and Metabolism, University of Ulsan College of Medicine,
Lee, Jeong Hyun - Department of Radiology and Research Institute of Radiology, University of Ulsan
ABSTRACT
OBJECTIVES: To evaluate the efficacy of radiofrequency ablation (RFA) in patients with recurrent thyroid cancer invading the airways.
METHODS: We reviewed patients who had undergone RFA for recurrent thyroid cancer in the central compartment after total thyroidectomy between January 2008 and December 2018. All tumors were classified according to their association with the laryngeal structure and trachea. The volume reduction rate (VRR) and complete disappearance rate were calculated, and their differences were determined relative to the association between the tumor and trachea. Complication rates associated with RFA were evaluated.
RESULTS: The study population included 119 patients with 172 recurrent tumors. Mean VRR was 81.2% ± 55.7%, with 124 tumors (72.1%) completely disappearing after a mean follow-up of 47.9 ± 35.4 months. The complete disappearance rate of recurrent tumors not in contact with the trachea was highest, followed by tumors forming acute angles, right angles, and obtuse angles with the trachea, and tumors with intraluminal tracheal invasion (p value < 0.001). The overall complication rate was 21.4%.
CONCLUSIONS: RFA is effective and safe for the local control of recurrent tumors in the central neck compartment after total thyroidectomy, even for tumors invading the airways, and may be considered an alternative to surgical resection. The inverse relationship between RFA efficacy and airway invasion suggests that early RFA may benefit patients with recurrent tumors in the central neck compartment. KEY POINTS: ? RFA achieved a mean VRR of 81.2% ± 55.7% and complete disappearance of 124 tumors (72.1%) after a mean follow-up of 47.9 ± 35.4 months. ? The complete disappearance rate of recurrent tumors not in contact with the trachea was the highest, followed by tumors forming acute angles, right angles, and obtuse angles with the trachea, and tumors with intraluminal tracheal invasion. ? Stent-assisted RFA may be a good alternative for palliative treatment of recurrent tumors with intraluminal tracheal invasion.
keyword
Neoplasm recurrence, local; Radiofrequency ablation; Thyroid cancer, papillary; Treatment outcome; Ultrasonography
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