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Huang Y, Zhao X, Yang Y, Qiu L, Zhao J, Qian L, Shi X. Efficacy and safety of laser ablation and microwave ablation to treat papillary thyroid microcarcinoma: A retrospective study. Am J Otolaryngol 2024; 45:104496. [PMID: 39173397 DOI: 10.1016/j.amjoto.2024.104496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 08/03/2024] [Accepted: 08/06/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVE To retrospectively analyze the efficacy and safety of laser ablation (LA) and microwave ablation (MWA) in the treatment of papillary thyroid microcarcinoma (PTMC). METHODS This was a retrospective study of 103 patients (109 nodules) who underwent thermal ablation for PTMC between October 2019 and March 2023; 61 underwent LA and 48 underwent MWA. The mean patients' age was 43.50 ± 12.42 years. After ablation, changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis, and complications were evaluated and recorded. The feasibility, success rate, and safety of LA and MWA were analyzed. RESULTS Complete absence of enhancement on contrast-enhanced ultrasonography was observed in all target tumors after ablation. At the last follow-up, the mean volume of the PTMC nodules decreased from 0.09 ± 0.09 to 0.03 ± 0.03 ml (LA group) and from 0.11 ± 0.10 to 0.06 ± 0.08 ml (MWA group) (both, P < 0.05). There was no significant difference in volume change between the groups (P (groups): 0.520; P (groups over time): 0.423), indicating similar efficacy between the groups. There was also no significant difference in the volume reduction rate between the groups during follow-up, except for at 3 months (P = 0.023). The complication rates did not differ between the LA group (8.2 %) and MWA group (6.3 %) (P > 0.05). CONCLUSION During the short-term follow-up, ultrasound-guided LA and MWA were effective and safe for PTMC, and there were no significant differences in treatment outcomes between the methods.
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Affiliation(s)
- Yuqing Huang
- Department of Ultrasound, Capital Medical University Beijing Friendship Hospital, Beijing 100050, China; Department of Ultrasound, Aerospace Center Hospital, Beijing 100049, China
| | - Xinyu Zhao
- Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Yu Yang
- Department of Ultrasound, Capital Medical University Beijing Friendship Hospital, Beijing 100050, China
| | - Lanyan Qiu
- Department of Ultrasound, Capital Medical University Beijing Friendship Hospital, Beijing 100050, China
| | - Junfeng Zhao
- Department of Ultrasound, Capital Medical University Beijing Friendship Hospital, Beijing 100050, China
| | - Linxue Qian
- Department of Ultrasound, Capital Medical University Beijing Friendship Hospital, Beijing 100050, China
| | - Xianquan Shi
- Department of Ultrasound, Capital Medical University Beijing Friendship Hospital, Beijing 100050, China.
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Li X, Yan L, Xiao J, Li Y, Yang Z, Zhang M, Luo Y. Long-Term Outcomes and Risk Factors of Radiofrequency Ablation for T1N0M0 Papillary Thyroid Carcinoma. JAMA Surg 2024; 159:51-58. [PMID: 37878294 PMCID: PMC10600723 DOI: 10.1001/jamasurg.2023.5202] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/26/2023] [Indexed: 10/26/2023]
Abstract
Importance Radiofrequency ablation (RFA) has gained increasing interest as a minimally invasive procedure to treat low-risk papillary thyroid carcinoma (PTC). Considering the indolent nature of this disease, studies in large populations with long follow-up would be invaluable to further substantiate the effectiveness of RFA. Objective To evaluate the long-term (58.5 months) outcomes of patients with T1N0M0 PTC who underwent RFA and investigate risk factors for local tumor progression (LTP). Design, Setting, and Participants This cohort study included 1613 patients aged 18 years or older with T1N0M0 PTC who underwent ultrasonography-guided RFA between January 2014 and December 2020 at the Chinese People's Liberation Army General Hospital in Beijing, China. Included in the analysis were patients with PTC (confirmed by biopsy) with a maximum diameter of 20 mm or less; no evidence of extrathyroidal extension (capsular disruption or involvement of perithyroidal tissue), lymph node metastasis, or distant metastasis on ultrasonography or computed tomography; and no evidence of an aggressive subtype of PTC on biopsy. Patients with PTC larger than 2 cm, less than 12 months of follow-up, or inadequate follow-up information were excluded. Data were analyzed in April 2023. Main Outcomes and Measures Long-term progression rate, disease-free survival, and complete tumor disappearance and their associations with patient and tumor characteristics. Disease-free survival was calculated using Kaplan-Meier analysis. Cox proportional hazards regression analyses were performed to assess risk factors for LTP and complete tumor disappearance. Results The study comprised 1613 patients (mean [SD] age, 43.3 [10.2] years; 1256 women [77.9%]) with 1834 T1N0M0 PTC tumors. During a mean follow-up of 58.5 months (range, 27 to 111 months), LTP was observed in 69 patients (4.3%), including 42 (2.6%) with tumor recurrence and 27 (1.7%) with tumor persistence. Cumulative disease-free survival rates at 1, 3, 5, and 8 years were 98.0%, 96.7%, 96.0%, and 95.7%, respectively. The overall complication rate was 2.0% (32 patients), with 6 (0.4%) major complications. Independent risk factors for LTP included subcapsular tumor location 2 mm or less from the capsule or trachea (hazard ratio [HR], 3.36; 95% CI, 2.02-5.59; P < .001) and multifocal tumors (HR, 2.27; 95% CI, 1.30-3.96; P = .004). Furthermore, 1376 patients (85.3%) showed complete tumor disappearance at follow-up ultrasonographic examination. Factors associated with complete tumor disappearance included age 40 years or less (HR, 0.78; 95% CI, 0.70-0.87; P < .001), stage T1a tumors (HR, 0.37; 95% CI, 0.31-0.45; P < .001), and unifocal tumors (HR, 0.50; 95% CI, 0.42-0.60; P < .001). Conclusions and Relevance In this cohort study, ultrasonography-guided RFA for T1N0M0 PTC had excellent long-term outcomes. Patients with unifocal T1N0M0 PTC and subcapsular tumor location more than 2 mm from the capsule or trachea may be the best candidates for RFA.
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Affiliation(s)
- Xinyang Li
- Department of Ultrasound, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Lin Yan
- Department of Ultrasound, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Jing Xiao
- Department of Ultrasound, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yingying Li
- Department of Ultrasound, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Zhen Yang
- Department of Ultrasound, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Mingbo Zhang
- Department of Ultrasound, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yukun Luo
- Department of Ultrasound, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
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Gao X, Yang Y, Wang Y, Huang Y. Efficacy and safety of ultrasound-guided radiofrequency, microwave and laser ablation for the treatment of T1N0M0 papillary thyroid carcinoma on a large scale: a systematic review and meta-analysis. Int J Hyperthermia 2023; 40:2244713. [PMID: 37604507 DOI: 10.1080/02656736.2023.2244713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND To analyze the efficacy and safety of radiofrequency ablation (RFA), microwave ablation (MWA) and laser ablation (LA) in T1N0M0 papillary thyroid carcinoma (PTC) patients by evaluating data on several outcomes on a large scale. MATERIALS AND METHODS Literature searches were conducted in PUBMED, EMBASE and the Cochrane Library for studies of thermal ablation (TA) for treating T1N0M0 PTC. Data on the volume reduction rate (VRR) at the 12-month follow-up and final follow-up, complete disappearance rate, local recurrence rate, lymph node metastasis rate, and complication rate of RFA, MWA and LA were evaluated separately. RFA effects were compared between T1aN0M0 and T1bN0M0 patients. RESULTS A total of 36 eligible studies were included. RFA presented superior efficacy than MWA in 12-month VRR. At the final follow-up, the difference was slight in subgroups, showing a significant reduction. The complete disappearance rate of LA (93.00%) was higher than that of RFA (81.00%) and MWA (71.00%). Additionally, the local recurrence rate pooled proportions of MWA and RFA were both 2.00%, lower than that of the LA group (3.00%). There was no event of distant metastasis. The lymph node metastasis rates were similar, as RFA (1.00%) had the lowest. For minor complication rates, the pooled proportions of RFA (3.00%) were smaller than those of LA (6.00%) and MWA (13.00%). T1aN0M0 lesions presented with better outcomes than T1bN0M0 lesions. CONCLUSION RFA, MWA and LA were reliable in curing PTC, and RFA presented advantages in most outcomes. T1aN0M0 patients may experience fewer side effects than T1bN0M0 patients.
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Affiliation(s)
- Xuemeng Gao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yang Yang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yitong Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ying Huang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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Han ZY, Dou JP, Zheng L, Che Y, Yu MA, Wang SR, Wang H, Cong ZB, He JF, Qian TG, Hu QH, He GZ, Liu G, Yu SY, Guo JQ, Jiang TA, Feng RF, Li QY, Chen XJ, Zhu YL, Wei Y, Liu LH, Wang X, Qi LN, Liang P. Safety and efficacy of microwave ablation for the treatment of low-risk papillary thyroid microcarcinoma: a prospective multicenter study. Eur Radiol 2023; 33:7942-7951. [PMID: 37294329 DOI: 10.1007/s00330-023-09802-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 03/21/2023] [Accepted: 03/26/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To assess the safety and efficacy of ultrasound-guided thermal ablation for low-risk papillary thyroid microcarcinoma (PTMC) via a prospective multicenter study. METHODS From January 2017 through June 2021, low-risk PTMC patients were screened. The management details of active surveillance (AS), surgery, and thermal ablation were discussed. Among patients who accepted thermal ablation, microwave ablation (MWA) was performed. The main outcome was disease-free survival (DFS). The secondary outcomes were tumor size and volume changes, local tumor progression (LTP), lymph node metastasis (LNM), and complication rate. RESULTS A total of 1278 patients were included in the study. The operation time of ablation was 30.21 ± 5.14 min with local anesthesia. The mean follow-up time was 34.57 ± 28.98 months. Six patients exhibited LTP at 36 months, of whom 5 patients underwent a second ablation, and 1 patient received surgery. The central LNM rate was 0.39% at 6 months, 0.63% at 12 months, and 0.78% at 36 months. Of the 10 patients with central LNM at 36 months, 5 patients chose ablation, 3 patients chose surgery and the other 2 patients chose AS. The overall complication rate was 1.41%, and 1.10% of patients developed hoarseness of the voice. All of the patients recovered within 6 months. CONCLUSIONS Thermal ablation of low-risk PTMC was observed to be safe and efficacious with few minor complications. This technique may help to bridge the gap between surgery and AS as treatment options for patients wishing to have their PTMC managed in a minimally invasive manner. CLINICAL RELEVANCE STATEMENT This study proved that microwave ablation is a safe and effective treatment method for papillary thyroid microcarcinoma. KEY POINTS Percutaneous US-guided microwave ablation of papillary thyroid microcarcinoma is a very minimally invasive treatment under local anesthesia during a short time period. The local tumor progression and complication rate of microwave ablation in the treatment of papillary thyroid microcarcinoma are very low.
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Affiliation(s)
- Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, China
| | - Jian-Pin Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, China
| | - Lin Zheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, China
| | - Ying Che
- Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ming-An Yu
- Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Beijing, Chaoyang District, China
| | - Shu-Rong Wang
- Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, No. 126, Xian Tai Street, Changchun, China
| | - Zhi-Bin Cong
- Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Jun-Feng He
- Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, 41 Linyin Road, Kunqu District, Baotou City, Inner Mongolia Autonomous Region, China
| | - Tong-Gang Qian
- Department of Ultrasound, Zunhua People's Hospital, Hebei Province, Huaming Road, Zunhua, Hebei Province, China
| | - Qiao-Hong Hu
- Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, 158 Shangtang Road, Xiacheng District, Hangzhou City, Zhejiang, China
| | - Guang-Zhi He
- Department of Ultrasound, Shenzhen Hospital of University of Chinese Academy of Sciences, Shenzhen, China
| | - Geng Liu
- Department of Ultrasound, Wuhai People's Hospital, No. 29, Huanghe East Street, Haibowan District, Wuhai City, Inner Mongolia Autonomous Region, China
| | - Song-Yuan Yu
- Department of Medical Ultrasound, the First Center of Minimally Invasive Treatment for, TumorShanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jian-Qin Guo
- Department of Interventional Ultrasound, Qinghai Provincial People's Hospital, Gonghe Road, Chengdong District, Xining City, Qinghai Province, China
| | - Tian-An Jiang
- Department of Ultrasound Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Zhejiang, Hangzhou, China
| | - Rui-Fa Feng
- Department of Ultrasound, breast and thyroid surgery, the Second Affiliated Hospital of Guilin Medical University, No.212, Renmin Road, Lingui District, Guilin City, Guangxi Province, China
| | - Qin-Ying Li
- Department of Interventional Ultrasound, Puyang Traditional Chinese medicine hospital, No.135 Shengli Road, Hualong District, Puyang City, Henan, China
| | - Xiao-Jun Chen
- Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou City, Zhejiang Province, China
| | - Ya-Lin Zhu
- Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ying Wei
- Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Beijing, Chaoyang District, China
| | - Li-Hong Liu
- Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Xue Wang
- Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Li-Na Qi
- Department of Interventional Ultrasound, Qinghai Provincial People's Hospital, Gonghe Road, Chengdong District, Xining City, Qinghai Province, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, China.
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Chen Z, Zhang W, He W. Ultrasound-guided thermal ablation for papillary thyroid microcarcinoma: A systematic review. Clin Endocrinol (Oxf) 2023; 98:296-305. [PMID: 36471482 DOI: 10.1111/cen.14857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Thyroidectomy is the first-line treatment for papillary thyroid microcarcinoma (PTMC), but often involves aggressive overtreatment. Thermal ablation (TA) has been gradually used for the treatment of recurrent PTMC. However, it is not recommended for the treatment of primary PTMC according to the Korean and Italian guidelines. Therefore, this systematic review aimed to analyse the indications, efficacy, and safety of TA in the treatment of PTMC. DESIGN Systematic review. PATIENTS AND MEASUREMENTS A search strategy was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A total of 27 articles were included in this study until January 2022. RESULTS According to current guidelines and studies, we divided the indications of TA for PTMC into six primary and three secondary indications. Laser ablation (LA) has the advantages of a small needle, accurate output energy and precision ablation, and it is safe to important organs around the lesion. The patients recover quickly after radiofrequency ablation (RFA), with no major complications, recurrence, or lymph node metastasis. The volume reduction rate after RFA was the highest, followed by microwave ablation and LA, and the improvement in patient quality of life after TA was significantly better than after thyroidectomy. CONCLUSIONS TA is an effective alternative method for surgery in the treatment of low-risk PTMC and has the advantages of being minimally invasive, economical, having less bleeding and having a high postoperative quality of life.
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Affiliation(s)
- Zhiguang Chen
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Ou D, Chen C, Jiang T, Xu D. Research Review of Thermal Ablation in the Treatment of Papillary Thyroid Carcinoma. Front Oncol 2022; 12:859396. [PMID: 35847945 PMCID: PMC9283792 DOI: 10.3389/fonc.2022.859396] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/24/2022] [Indexed: 12/24/2022] Open
Abstract
Background Minimally invasive treatment of thyroid tumors has become increasingly common, but has mainly focused on benign thyroid tumors, whereas thermal ablation of thyroid cancer remains controversial. Clinical studies analyzing the efficacy of thermal ablation of papillary thyroid carcinoma (PTC) have been conducted in several countries to verify its safety. Here, we screened and reviewed recent studies on the efficacy and safety of thermal ablation of PTC as well as psychological assessment, patient prognosis, recurrence, and factors affecting ablation. Summary The most significant controversy surrounding ablative treatment of PTC centers on its effectiveness and safety, and >40 studies have been conducted to address this issue. The studies include papillary thyroid microcarcinoma (PTMC) and non-PTMC, single PTC and multiple PTC, and controlled studies of ablative therapy and surgical treatment. In general, ablation techniques can be carefully performed and promoted under certain conditions and with active follow-up of postoperative patients. Ablation is a promising alternative treatment especially in patients who are inoperable. Conclusions Clinical studies on PTC ablation have provided new perspectives on local treatment. However, because PTC grows very slowly, it is an indolent tumor; therefore, studies with larger sample sizes and extended post-procedure follow-ups are necessary to confirm the investigators’ hypotheses.
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Affiliation(s)
- Di Ou
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, China
| | - Chen Chen
- Graduate School, Wannan Medical College, Wuhu, China
| | - Tian Jiang
- The Postgraduate Training Base, Wen Zhou Medical University, Hangzhou, China
| | - Dong Xu
- Department of Ultrasound, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, China
- *Correspondence: Dong Xu,
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Zhang L, Zhang GP, Zhan WW, Zhou W. The feasibility and efficacy of ultrasound-guided percutaneous laser ablation for multifocal papillary thyroid microcarcinoma. Front Endocrinol (Lausanne) 2022; 13:921812. [PMID: 36060950 PMCID: PMC9428260 DOI: 10.3389/fendo.2022.921812] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/26/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the feasibility and efficacy of percutaneous laser ablation (PLA) for patients with multifocal papillary thyroid microcarcinoma (PTMC). MATERIALS AND METHODS A cohort of patients who underwent ultrasound (US)-guided PLA for primary PTMC were enrolled in this study. The patients were divided into a multifocal PTMC (multi-PTMC) group and a unifocal PTMC (uni-PTMC) group. Before PLA, conventional US and contrast-enhanced ultrasound (CEUS) were performed to evaluate the PTMC and cervical lymph nodes. The operation time, energy, power, amount of isolation liquid, and complications during PLA were recorded. Patients were followed up at 2 days, 1 month, 3 months, and 6 months, and every 6 months after that. Volume reduction rate (VRR), local tumor recurrence, and lymph node metastasis after PLA were observed. RESULTS The study included 12 patients with 26 PTMCs and 60 patients with 60 PTMCs. The operation time, total energy, and amount of isolation liquid in the multi-PTMC group were more than those in the uni-PTMC group (p = 0.000, 0.007, and 0.020, respectively). The mean follow-up durations in multi-PTMC and uni-PTMC groups were 19.75 ± 11.46 months (6-36 months) and 16.33 ± 10.01 months (4-40 months), with a similar VRR of the ablated lesions in the two groups. One and three cases with newly developed PTMCs were observed in the multi-PTMC group and the uni-PTMC group during follow-up, respectively. There was no regrowth of treated lesions, lymph node metastasis, or distant metastasis. At the end of the follow-up, all the ablated lesions in the two groups completely disappeared or only remained scar strips. CONCLUSION PLA is a safe and effective technique for treating multifocal PTMC, which might be an alternative technique for patients who are not eligible or are unwilling to undergo surgery.
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Wang MH, Liu X, Wang Q, Zhang HW. Safety and efficacy of ultrasound-guided thermal ablation in treating T1aN0M0 and T1bN0M0 papillary thyroid carcinoma: A meta-analysis. Front Endocrinol (Lausanne) 2022; 13:952113. [PMID: 35966062 PMCID: PMC9363616 DOI: 10.3389/fendo.2022.952113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 06/21/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Papillary thyroid cancer (PTC) is the most common thyroid tumor, and early diagnosis and treatment can effectively improve prognosis. Many controversies surround the treatment method of T1N0M0 PTC. Recently, thermal ablation (TA) has shown some benefits in the treatment of PTC patients, but the safety and efficacy of its treatment remain controversial. This article performs a meta-analysis of TA in patients with T1aN0M0 and T1bN0M0 PTC. METHODS The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched for retrospective or prospective studies of TA for treating patients with T1N0M0 PTC from the database establishment to May 1, 2022. Data on volume reduction rate (VRR), disease progress, and complication rate were collected. In addition, a meta-analysis was performed using the Stata 12.0 and Review Manager 5.3. RESULTS A total of 9 eligible studies were included. Our study demonstrated the effectiveness of VRR and disease progress. The VRR was reduced after 3 months (-75.90%; 95% CI [-118.46-33.34%]), 6 months (34.33%; 95% CI [15.01-53.65%]), 12 months (78.69%; 95% CI [71.69-85.68%]), and 24 months (89.97%; 95% CI [84.00-95.94%]). The disease progress was 1.9% (95% CI [1.1-3.0]). Safety is justified by the complication rate, which was 6.5% (95% CI [3.5-10.2]). Pain and hoarseness were the most common complications, and no life-threatening complications were reported. Egger's test demonstrated that publication bias was acceptable. CONCLUSIONS TA is an effective and safe method for managing T1aN0M0 and T1bN0M0 papillary thyroid nodules.
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Affiliation(s)
- Mei-Huan Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiao Liu
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qian Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
- *Correspondence: Hua-Wei Zhang, ; Qian Wang,
| | - Hua-Wei Zhang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
- *Correspondence: Hua-Wei Zhang, ; Qian Wang,
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Bi XA, Li L, Xu R, Xing Z. Pathogenic Factors Identification of Brain Imaging and Gene in Late Mild Cognitive Impairment. Interdiscip Sci 2021; 13:511-520. [PMID: 34106420 DOI: 10.1007/s12539-021-00449-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Abstract
Mild cognitive impairment (MCI) is a dangerous signal of severe cognitive decline. It can be separated into two steps: early MCI (EMCI) and late MCI (LMCI). As the post-state of MCI and pre-state of Alzheimer's disease (AD), LMCI receives insufficient attention in the field of brain science, causing the internal mechanism of LMCI has not been well understood. To better explore the focus and pathological mechanism of LMCI, a method called genetic evolved random forest (GERF) is applied. Resting functional magnetic resonance imaging (rfMRI) and gene data are obtained from 62 subjects (36 LMCI and 26 normal controls), and Pearson correlation analysis is adopted to perform the multimodal fusion of two types of data to construct fusion features. We identified pathogenic brain regions and genes that are highly related to LMCI using GERF and achieves a good effect. Compared with the normal control (NC) group, the abnormal brain regions of LMCI are PUT.L, PreCG.L, IFGtriang.R, REC.R, DCG.R, PoCG.L, and HES.L, and the pathogenic genes are FHIT, RF00019, FRMD4A, PTPRD, and RBFOX1. More importantly, most of these risk genes and abnormal brain regions have been confirmed to be related to AD and MCI in previous studies. In this study, we mapped them to LMCI with higher accuracies, so as to provide a more robust understanding of the physiological mechanism of MCI.
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Affiliation(s)
- Xia-An Bi
- Hunan Provincial Key Laboratory of Intelligent Computing and Language Information Processing, Hunan Normal University, Changsha, People's Republic of China. .,College of Information Science and Engineering, Hunan Normal University, Changsha, People's Republic of China.
| | - Lou Li
- Hunan Provincial Key Laboratory of Intelligent Computing and Language Information Processing, Hunan Normal University, Changsha, People's Republic of China.,College of Information Science and Engineering, Hunan Normal University, Changsha, People's Republic of China
| | - Ruihui Xu
- Hunan Provincial Key Laboratory of Intelligent Computing and Language Information Processing, Hunan Normal University, Changsha, People's Republic of China.,College of Information Science and Engineering, Hunan Normal University, Changsha, People's Republic of China
| | - Zhaoxu Xing
- Hunan Provincial Key Laboratory of Intelligent Computing and Language Information Processing, Hunan Normal University, Changsha, People's Republic of China.,College of Information Science and Engineering, Hunan Normal University, Changsha, People's Republic of China
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