Efficacy of radiofrequency ablation for recurrent thyroid cancer invading the airways
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INTERVENTIONAL
Efficacy of radiofrequency ablation for recurrent thyroid cancer invading the airways Sae Rom Chung 1 & Jung Hwan Baek 1 & Young Jun Choi 1 & Tae-Yon Sung 2 & Dong Eun Song 3 & Tae Yong Kim 4 & Jeong Hyun Lee 1 Received: 15 May 2020 / Revised: 24 July 2020 / Accepted: 10 September 2020 # European Society of Radiology 2020
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. Keywords Neoplasm recurrence, local . Thyroid cancer, papillary . Ultrasonography . Radiofrequency ablation . Treatment outcome
* Jung Hwan Baek [email protected] 1
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
2
Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
3
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
4
Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Med
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