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Jing H, Yan L, Xiao J, Li X, Jiang B, Yang Z, Li Y, Sun B, Zhang M, Luo Y. Radiofrequency ablation for papillary thyroid microcarcinoma with a trachea-adjacent versus trachea-distant location. Int J Hyperthermia 2024; 41:2270671. [PMID: 38214143 DOI: 10.1080/02656736.2023.2270671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/09/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To evaluate the outcomes of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) adjacent to the trachea and compare them with those of PTMC distant from the trachea. METHODS Patients who received RFA for solitary low-risk PTMC between June 2014 and July 2020 were reviewed and classified into adjacent and distant groups. To balance between-group confounders, the propensity score matching approach was employed. Volume, volume reduction ratio (VRR), tumor disappearance, complications, and disease progression were assessed and compared between the groups. Furthermore, factors affecting disease progression were evaluated. RESULTS A total of 122 and 470 patients were included in the adjacent and distant groups, respectively. Overall VRR was 99.5% ± 3.1 and cumulative tumor disappearance rate was 99.4% after a mean follow-up time of 40.1 months ± 16.2. Overall disease progression and complications incidence were 3.7% and 1.0%, respectively. No substantial differences were observed between the two groups in the latest volume (0.8 mm3 ± 4.1 vs. 0.9 mm3 ± 4.2, p = .77), VRR (99.7% ± 1.6 vs. 99.5% ± 2.7, p = .75), cumulative tumor disappearance rate (92.6% vs. 94.2%, p = .58), and incidence of disease progression (4.1% vs. 4.5%, p = .70) and complication (1.7% vs. 0.8%, p = .86) after 1:2 matching. Additionally, tracheal adjacency exhibited no association with disease progression in multivariate Cox regression analysis (p = .73). CONCLUSION For eligible patients with PTMC located adjacent to or distant from the trachea, RFA may offer a safe and effective alternative treatment method.
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Affiliation(s)
- Haoyu Jing
- Chinese PLA Medical School, Beijing, China
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lin Yan
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jing Xiao
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xinyang Li
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo Jiang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zhen Yang
- Chinese PLA Medical School, Beijing, China
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yingying Li
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bin Sun
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Mingbo Zhang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yukun Luo
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China
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Qin S, Lin XT, Wang YM, Chen Y, Cui R, Liu GJ. Percutaneous ultrasound-guided drainage of pneumomediastinum through the retropharyngeal space: a case report. Gastroenterol Rep (Oxf) 2022; 10:goac040. [PMID: 35966630 PMCID: PMC9366184 DOI: 10.1093/gastro/goac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/18/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Si Qin
- Department of Medical Ultrasonics, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Xu-Tao Lin
- Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Yi-Min Wang
- Department of Medical Ultrasonics, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Yao Chen
- Department of Medical Ultrasonics, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Rui Cui
- Department of Medical Ultrasonics, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Guang-Jian Liu
- Department of Medical Ultrasonics, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
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Mauri G, Orsi F, Carriero S, Della Vigna P, De Fiori E, Monzani D, Pravettoni G, Grosso E, Manzoni MF, Ansarin M, Giugliano G. Image-Guided Thermal Ablation as an Alternative to Surgery for Papillary Thyroid Microcarcinoma: Preliminary Results of an Italian Experience. Front Endocrinol (Lausanne) 2020; 11:575152. [PMID: 33488514 PMCID: PMC7820745 DOI: 10.3389/fendo.2020.575152] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/06/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To report the results of our preliminary experience in treating patients with papillary thyroid microcarcinoma (PTMC) with image-guided thermal ablation, in particular estimating the feasibility, safety and short-term efficacy. MATERIALS AND METHODS From 2018 patients with cytologically proven PTMC < 10 mm were discussed in a multidisciplinary team and evaluated for feasibility of image-guided thermal ablation. In case of technical feasibility, the three possible alternatives (i.e., image-guided thermal ablation, surgery, and active surveillance) were discussed with patients. Patients who agreed to be treated with image guided thermal ablation underwent radiofrequency (RFA) or laser ablation under local anesthesia and conscious sedation. Treatment feasibility, technical success, technique efficacy, change in thyroid function tests, side effects, minor and major complications, patients satisfaction and pain/discomfort perception during and after treatment, and disease recurrence during follow-up were recorded. RESULTS A total of 13 patients were evaluated, and 11/13 (84.6%) patients (9 female, 2 male, mean age 49.3 ± 8.7 years) resulted suitable for image-guided thermal ablation. All 11 patients agreed to be treated with image-guided thermal ablation. In addition, 3/11 (27.3%) were treated with laser ablation and 8/11 (72.7%) with RFA. All procedures were completed as preoperatively planned (technical success 100%). Technique efficacy was achieved in all 11/11 (100%) cases. Ablated volume significantly reduced from 0.87 ± 0.67 ml at first follow-up to 0.17 ± 0.36 at last follow-up (p = 0.003). No change in thyroid function tests occurred. No minor or major complications occurred. All patients graded 10 the satisfaction for the treatment, and mean pain after the procedure was reported as 1.4 ± 1.7, and mean pain after the procedure as 1.2 ± 1.1 At a median follow-up of 10.2 months (range 1.5-12 months), no local recurrence or distant metastases were found. CONCLUSIONS Image guided thermal ablations appear to be feasible and safe in the treatment of PTMC. These techniques hold the potential to offer patients a minimally invasive curative alternative to surgical resection or active surveillance. These techniques appear to be largely preferred by patients.
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Affiliation(s)
- Giovanni Mauri
- Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy
- Divisione di Radiologia interventistica, Istituto Europeo di Oncologia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Franco Orsi
- Divisione di Radiologia interventistica, Istituto Europeo di Oncologia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Serena Carriero
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milan, Italy
- *Correspondence: Serena Carriero,
| | - Paolo Della Vigna
- Divisione di Radiologia interventistica, Istituto Europeo di Oncologia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Elvio De Fiori
- Unità di Radiologia Clinico Diagnostica, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - Dario Monzani
- Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy
- Divisione di Psiconcologia, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy
- Divisione di Psiconcologia, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - Enrica Grosso
- Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - Marco F. Manzoni
- Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - Gioacchino Giugliano
- Divisione di Otorinolaringoiatria e Chirurgia Cervico Facciale, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
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