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Lui MS, Patel KN. Current guidelines for the application of radiofrequency ablation for thyroid nodules: a narrative review. Gland Surg 2024; 13:59-69. [PMID: 38323237 PMCID: PMC10839702 DOI: 10.21037/gs-23-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/28/2023] [Indexed: 02/08/2024]
Abstract
Background and Objective Thyroid nodules are frequently incidentally found on physical exam or imaging for an unrelated work-up. Although surgery remains the gold standard for treating symptomatic benign and/or malignant thyroid nodules, radiofrequency ablation (RFA) has emerged as a minimally invasive treatment option for high risk patients and those who decline surgery. The novel application of RFA to treat thyroid disease was originally described for symptomatic, benign thyroid nodules. Since then, several studies have tried to expand its indication to treat primary and recurrent well-differentiated thyroid cancer. The high success rates and the low complication profile, has allowed for quick adoption of RFA as a treatment option for well-selected patients with benign thyroid nodules and locoregional recurrent thyroid malignancy. As such, multidisciplinary guidelines and consensus statements were developed to standardize indications, techniques, outcome measures, and follow-up to ensure the best patient care. This article summarizes the current indications and recommendations to help guide clinicians on how best to effectively and safely utilize RFA to treat thyroid disease. Methods A PubMed/MEDLINE search between 2000-2022 using a combination of "radiofrequency ablation", "RFA", "thyroid nodule", and "guidelines" was conducted. The inclusion criteria were articles published in English which offered recommendations on RFA use for thyroid nodules. Key Content and Findings For symptomatic, benign thyroid nodules, RFA is effective at significantly reducing nodule volume. For large nodules, multiple RFA sessions may be needed to achieve clinically significant volume reduction. Patients undergoing RFA for autonomously functioning thyroid nodules may see symptomatic relief but success rates are variable. RFA may serve a curative or palliative role in recurrent well-differentiated thyroid cancers. There is little data describing the use of RFA for primary well-differentiated thyroid cancer >1 cm and the role of RFA for thyroid microcarcinomas remains controversial. Conclusions RFA is a safe minimally invasive technique and may be considered, in appropriate circumstances, a first-line treatment option for benign thyroid nodules. Practices adopting RFA will likely increase as more clinicians become familiar with this technique, highlighting the importance of developing standardized guidelines.
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Affiliation(s)
| | - Kepal N. Patel
- Division of Endocrine Surgery, Department of Surgery, New York University Langone Health, New York, NY, USA
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Shaha AR. Aggressive Subtypes of Papillary Microcarcinoma. J Clin Endocrinol Metab 2023; 108:e489-e490. [PMID: 36702758 DOI: 10.1210/clinem/dgad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 01/18/2023] [Indexed: 01/28/2023]
Affiliation(s)
- Ashok R Shaha
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
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Kung FP, Lim YP, Chao WY, Zhang YS, Yu HI, Tai TS, Lu CH, Chen SH, Li YZ, Zhao PW, Yen YP, Lee YR. Piperlongumine, a Potent Anticancer Phytotherapeutic, Induces Cell Cycle Arrest and Apoptosis In Vitro and In Vivo through the ROS/Akt Pathway in Human Thyroid Cancer Cells. Cancers (Basel) 2021; 13:cancers13174266. [PMID: 34503074 PMCID: PMC8428232 DOI: 10.3390/cancers13174266] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 01/20/2023] Open
Abstract
Simple Summary There is no effective treatment currently available for patients with anaplastic, recurrent papillary, or follicular thyroid cancers. Reactive oxygen species (ROS) are believed to hold promise as a new therapeutic strategy for multiple human cancers. However, studies on ROS inducers for human thyroid cancer treatment are scarce. This study assesses the anticancer activity and the detailed downstream mechanisms of piperlongumine, a ROS inducer, in human thyroid cancer cells. We demonstrate that piperlongumine inhibits cell proliferation, regulates the cell cycle, and induces cellular apoptosis in various types of human thyroid cancer cells. The antihuman thyroid cancer activity of piperlongumine was through ROS induction, and it further suppressed the downstream Akt signaling pathway to elevate mitochondria-dependent apoptosis. A mouse xenograft study demonstrated that piperlongumine was safe and could inhibit tumorigenesis in vivo. The present study provides strong evidence that piperlongumine can be used as a therapeutic candidate for human thyroid cancers. Abstract Thyroid cancer (TC) is the most common endocrine malignancy, and its global incidence has steadily increased over the past 15 years. TC is broadly divided into well-differentiated, poorly differentiated, and undifferentiated types, depending on the histological and clinical parameters. Thus far, there are no effective treatments for undifferentiated thyroid cancers or advanced and recurrent cancer. Therefore, the development of an effective therapeutic is urgently needed for such patients. Piperlongumine (PL) is a naturally occurring small molecule derived from long pepper; it is selectively toxic to cancer cells by generating reactive oxygen species (ROS). In this study, we demonstrate the potential anticancer activity of PL in four TC cell lines. For this purpose, we cultured TC cell lines and analyzed the following parameters: Cell viability, colony formation, cell cycle, apoptosis, and cellular ROS induction. PL modulated the cell cycle, induced apoptosis, and suppressed tumorigenesis in TC cell lines in a dose- and time-dependent manner through ROS induction. Meanwhile, an intrinsic caspase-dependent apoptosis pathway was observed in the TC cells under PL treatment. The activation of Erk and the suppression of the Akt/mTOR pathways through ROS induction were seen in cells treated with PL. PL-mediated apoptosis in TC cells was through the ROS-Akt pathway. Finally, the anticancer effect and safety of PL were also demonstrated in vivo. Our findings indicate that PL exhibits antitumor activity and has the potential for use as a chemotherapeutic agent against TC. This is the first study to show the sensitivity of TC cell lines to PL.
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Affiliation(s)
- Fang-Ping Kung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (F.-P.K.); (H.-I.Y.); (T.-S.T.); (C.-H.L.); (Y.-P.Y.)
| | - Yun-Ping Lim
- Department of Pharmacy, College of Pharmacy, China Medical University, Taichung 406040, Taiwan;
- Department of Internal Medicine, China Medical University Hospital, Taichung 404332, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung 404332, Taiwan
| | - Wen-Ying Chao
- Department of Nursing, Min-Hwei College of Health Care Management, Tainan 73658, Taiwan;
| | - Yi-Sheng Zhang
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (Y.-S.Z.); (S.-H.C.); (Y.-Z.L.); (P.-W.Z.)
| | - Hui-I Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (F.-P.K.); (H.-I.Y.); (T.-S.T.); (C.-H.L.); (Y.-P.Y.)
| | - Tsai-Sung Tai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (F.-P.K.); (H.-I.Y.); (T.-S.T.); (C.-H.L.); (Y.-P.Y.)
| | - Chieh-Hsiang Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (F.-P.K.); (H.-I.Y.); (T.-S.T.); (C.-H.L.); (Y.-P.Y.)
| | - Shu-Hsin Chen
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (Y.-S.Z.); (S.-H.C.); (Y.-Z.L.); (P.-W.Z.)
| | - Yi-Zhen Li
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (Y.-S.Z.); (S.-H.C.); (Y.-Z.L.); (P.-W.Z.)
| | - Pei-Wen Zhao
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (Y.-S.Z.); (S.-H.C.); (Y.-Z.L.); (P.-W.Z.)
| | - Yu-Pei Yen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan; (F.-P.K.); (H.-I.Y.); (T.-S.T.); (C.-H.L.); (Y.-P.Y.)
| | - Ying-Ray Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence:
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Tufano RP, Pace-Asciak P, Russell JO, Suárez C, Randolph GW, López F, Shaha AR, Mäkitie A, Rodrigo JP, Kowalski LP, Zafereo M, Angelos P, Ferlito A. Update of Radiofrequency Ablation for Treating Benign and Malignant Thyroid Nodules. The Future Is Now. Front Endocrinol (Lausanne) 2021; 12:698689. [PMID: 34248853 PMCID: PMC8264548 DOI: 10.3389/fendo.2021.698689] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022] Open
Abstract
Thermal and chemical ablation are minimally invasive procedures that avoid removal of the thyroid gland and target symptomatic nodules directly. Internationally, Radiofrequency ablation (RFA) is among one of the most widely used thermal ablative techniques, and is gaining traction in North America. Surgery remains the standard of care for most thyroid cancer, and in the right clinical setting, Active Surveillance (AS) can be a reasonable option for low risk disease. Minimally invasive techniques have emerged as an alternative option for patients deemed high risk for surgery, or for those patients who wish to receive a more active treatment approach compared to AS. Herein, we review the literature on the safety and efficacy of RFA for treating benign non-functioning thyroid nodules, autonomously functioning thyroid nodules, primary small low risk thyroid cancer (namely papillary thyroid cancer) as well as recurrent thyroid cancer.
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Affiliation(s)
- Ralph P. Tufano
- Division of Otolaryngology – Endocrine Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States
- *Correspondence: Ralph P. Tufano,
| | - Pia Pace-Asciak
- Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Jonathon O. Russell
- Division of Otolaryngology – Endocrine Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States
| | - Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain
| | - Gregory W. Randolph
- Division of Otolaryngology - Endocrine Head and Neck Surgery, Harvard University, Massachusetts Eye and Ear Infirmary, Boston, MA, United States
| | - Fernando López
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain
- Institutode Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo CIBERONC-ISCIII, Oviedo, Spain
| | - Ashok R. Shaha
- Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, United States
| | - Antti Mäkitie
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juan P. Rodrigo
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology Department, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Mark Zafereo
- Department of Head & Neck Surgery, MD Anderson Cancer Center, Houston, TX, United States
| | - Peter Angelos
- Department of Surgery, Bucksbaum Institute for Clinical Excellence, University of Chicago, Chicago, IL, United States
| | - Alfio Ferlito
- The University of Udine School of Medicine, International Head and Neck Scientific Group, Padua, Italy
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Ora M, Nazar AH, Pradhan PK, Mishra P, Barai S, Arya A, Dixit M, Parashar A, Gambhir S. The Utility of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Differentiated Thyroid Cancer Patients with Biochemical Recurrence and Negative Whole-Body Radioiodine Scintigraphy and Evaluation of the Possible Role of a Limited Regional Scan. Indian J Nucl Med 2020; 35:203-209. [PMID: 33082675 PMCID: PMC7537939 DOI: 10.4103/ijnm.ijnm_5_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose of the Study 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is used in the management of recurrent differentiated thyroid cancer (DTC) patients presented with rising thyroglobulin (Tg) or anti-Tg antibody (Atg) levels and negative whole-body I-131 scan (WBS). We aimed to evaluate the utility of regional or limited PET/CT in a large population preset with variable Tg/(ATg) levels. Materials and Methods In a retrospective study, we analyzed 137 PET/CT done on DTC patients presented with raised Tg/Atg and negative WBS. Retrospective evaluation of other available clinical information was done. Results One hundred and thirty-seven patients aged 8-72 years (41 ± 17.7 years) were included in the study. Eighty-nine (64.9%) patients had positive findings on 18F-FDG PET-CT. It included thyroid bed recurrence, cervical, mediastinal lymphadenopathy, lung, and bone lesions. In addition, 36 patients had metabolically inactive lung nodules detected on CT. Serum Tg and female sex were the only predictors for a positive PET scan. In most (97.1%) of the patients, the disease was limited to the neck and thoracic region. Conclusions PET/CT is an excellent imaging modality for evaluating DTC patients presented with biochemical recurrence. It not only finds the disease in more than 80% of the patients but also detects distant metastatic disease, which precludes regional therapies. Lesions were noted mostly in the neck and thoracic region with very few distant skeletal metastases (4/137 patients). In most of the patients, routine vertex to mid-thigh imaging could be avoided.
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Affiliation(s)
- Manish Ora
- Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Aftab Hasan Nazar
- Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | | | - Prabhakar Mishra
- Department of Biostatistics and Health Informatics, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Sukanta Barai
- Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Amitabh Arya
- Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Manish Dixit
- Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Ashutosh Parashar
- Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Sanjay Gambhir
- Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India
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Kang JH, Jung DW, Pak KJ, Kim IJ, Kim HJ, Cho JK, Shin SC, Wang SG, Lee BJ. Prognostic implication of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in patients with recurrent papillary thyroid cancer. Head Neck 2017; 40:94-102. [PMID: 29130586 DOI: 10.1002/hed.24967] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/03/2017] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Fluorine-18 fluorodeoxyglucose positron emission tomography/CT (18 F-FDG PET/CT) has been widely accepted as an effective method for detecting recurrent papillary thyroid cancer (PTC) in patients with increased serum thyroglobulin (Tg) or Tg antibody (TgAb) levels and negative whole-body scintigraphy (WBS) results. The role of WBS as a diagnostic tool in detecting recurrence has relatively decreased recently. However, only a few studies have examined the usefulness of 18 F-FDG PET/CT for evaluating patients with recurrent PTC, regardless of the WBS results. The purpose of this analysis was to evaluate the diagnostic value and prognostic role of 18 F-FDG PET/CT for patients with recurrent PTC, irrespective of their WBS results. METHODS Sixty-six patients with locoregional recurrent PTC who underwent 18 F-FDG PET/CT and neck CT within 6 months before surgical treatment were included in this retrospective analysis. Imaging findings were compared with postoperative histopathologic results. The diagnostic values of 18 F-FDG PET/CT and neck CT were compared according to the serum Tg and TgAb levels and cervical levels. Each patient's status at the last follow-up was also reviewed, and survival probabilities were estimated using the Kaplan-Meier plot. RESULTS The sensitivity, specificity, and diagnostic accuracy of 18 F-FDG PET/CT for the entire patient group were 38.5%, 90.2%, and 58.3%, respectively. The corresponding neck CT values were 55.0%, 85.7%, and 66.7%, respectively. According to the serum Tg and TgAb levels, except for the specificity, most diagnostic values of 18 F-FDG PET/CT were worse than those of the neck CTs, with or without statistical significance. For the high maximum standardized uptake value (SUVmax) group (SUVmax >10) and the low SUVmax group, the median locoregional disease-free survival times were 33.3 months and 81.8 months, respectively (P < .001). CONCLUSION The diagnostic value of 18 F-FDG PET/CT for localizing recurrent lesions was worse than that of the neck CT, irrespective of the WBS results. However, patients with a higher SUVmax showed a significantly worse prognosis than did those with a lower SUVmax. Therefore, we suggest that, in patients with recurrent PTC, 18 F-FDG PET/CT should be considered for prognostication rather than diagnosis.
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Affiliation(s)
- Ji-Hun Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
| | - Da-Woon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
| | - Kyoung-June Pak
- Department of Nuclear Medicine, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
| | - In-Ju Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
| | - Hak-Jin Kim
- Department of Radiology, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
| | - Jae-Keun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Ilsan Paik Hospital, Ilsan, South Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
| | - Soo-Geun Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
| | - Byung-Joo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, South Korea
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Chinn SB, Zafereo ME, Waguespack SG, Edeiken BS, Roberts DB, Clayman GL. Long-Term Outcomes of Lateral Neck Dissection in Patients with Recurrent or Persistent Well-Differentiated Thyroid Cancer. Thyroid 2017; 27:1291-1299. [PMID: 28806882 DOI: 10.1089/thy.2017.0203] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Well-differentiated thyroid carcinoma (WDTC) has a high predilection for regional metastatic spread. Rates for WDTC lateral neck recurrence are reported to be as high as 24% in patients after initial thyroidectomy, lateral neck surgery, and adjuvant radioactive (RAI) iodine treatment. The objective of the study was to evaluate the efficacy, safety, and long-term outcome of comprehensive lateral neck dissection (LND) of levels II-V for recurrent or persistent WDTC in a tertiary referral center. METHODS This study retrospectively analyzed the standardized approach of LND for recurrent WDTC in the lateral neck compartment. Survival was analyzed by Cox regression analysis. RESULTS Three hundred and seven patients underwent 429 LND for cytopathology-confirmed lateral neck recurrent WDTC at the University of Texas MD Anderson Cancer Center between 1994 and 2012. The vast majority (90%) of patients were originally treated elsewhere. Multilevel lateral neck dissection had been originally performed in 80% of patients, with 17% having undergone at least two previous operations. Two hundred and sixty-seven (87%) patients had previous RAI. The most common levels of recurrence were levels III and IV (33% and 33%, respectively). Postoperative complications were seen in 7% of patients. Median follow-up was 7.2 years. In-field lateral neck control was 96% at 10 years. Overall lateral neck regional control, overall survival (OS), and disease-specific survival (DSS) at 10 years was 88%, 78%, and 91%, respectively. When stratifying by age (<24 years, 24-50 years, and >50 years), OS and DSS was significantly better in patients <50 years (OS: p < 0.001; DSS: p < 0.001). However, there was worse overall lateral neck control in the younger group (<24 years; p = 0.04). Regional recurrence after salvage LND occurred within a median time interval of 20.0 months (2.9-121.3 months), of which 2% (8/429) developed in-field lateral neck recurrences. Of those with any lateral neck recurrence after salvage LND, 24/30 (80%) patients successfully underwent another LND, resulting in an ultimate 98% lateral neck regional control rate. CONCLUSIONS Expert comprehensive LND of levels II-V is associated with few perioperative complications and results in very high in-field regional control rate and ultimate lateral neck control in recurrent/persistent WDTC.
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Affiliation(s)
- Steven B Chinn
- 1 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center , Houston, Texas
- 2 Department of Otolaryngology-Head and Neck Surgery, University of Michigan , Ann Arbor, Michigan
| | - Mark E Zafereo
- 1 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Steven G Waguespack
- 3 Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Beth S Edeiken
- 4 Department of Radiology, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Dianna B Roberts
- 1 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Gary L Clayman
- 1 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center , Houston, Texas
- 5 Clayman Thyroid Surgery and Thyroid Cancer Center, Thyroid and Parathyroid Institute , Tampa General Hospital, Tampa, Florida
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Chung SR, Suh CH, Baek JH, Park HS, Choi YJ, Lee JH. Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. Int J Hyperthermia 2017; 33:920-930. [PMID: 28565997 DOI: 10.1080/02656736.2017.1337936] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE We performed a systematic review and meta-analysis to evaluate the safety of radiofrequency ablation (RFA) for the treatment of benign thyroid nodules and recurrent thyroid cancers. MATERIALS AND METHODS Ovid-MEDLINE, EMBASE, and Library of Cochrane databases were searched up to 12 July 2016 for studies on the safety of RFA for treating benign thyroid nodules or recurrent thyroid cancers. Pooled proportions of overall and major complications were assessed using random-effects modelling. Heterogeneity among studies was determined using the χ2 statistic for the pooled estimates and the inconsistency index I2. RESULTS A total of 24 eligible studies were included, giving a sample size of 2421 patients and 2786 thyroid nodules. 41 major complications and 48 minor complications of RFA were reported, giving a pooled proportion of 2.38% for overall RFA complications [95% confidence interval (CI): 1.42%-3.34%] and 1.35% for major RFA complications (95% CI: 0.89%-1.81%). There were no heterogeneities in either overall or major complications (I2 = 1.24%-21.79%). On subgroup analysis, the overall and major complication rates were significantly higher for malignant thyroid nodules than for benign thyroid nodules (p = 0.0011 and 0.0038, respectively). CONCLUSIONS RFA was found to be safe for the treatment of benign thyroid nodules and recurrent thyroid cancers.
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Affiliation(s)
- Sae Rom Chung
- a Department of Radiology and Research Institute of Radiology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea
| | - Chong Hyun Suh
- b Department of Radiology , Namwon Medical Center , Namwon-si , Republic of Korea
| | - Jung Hwan Baek
- a Department of Radiology and Research Institute of Radiology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea
| | - Hye Sun Park
- a Department of Radiology and Research Institute of Radiology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea
| | - Young Jun Choi
- a Department of Radiology and Research Institute of Radiology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea
| | - Jeong Hyun Lee
- a Department of Radiology and Research Institute of Radiology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea
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Scharpf J, Tuttle M, Wong R, Ridge D, Smith R, Hartl D, Levine R, Randolph G. Comprehensive management of recurrent thyroid cancer: An American Head and Neck Society consensus statement: AHNS consensus statement. Head Neck 2016; 38:1862-1869. [PMID: 27717219 DOI: 10.1002/hed.24513] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/04/2016] [Indexed: 01/12/2023] Open
Abstract
This American Head and Neck Society (AHNS) consensus statement focuses on the detection and management of recurrent thyroid cancer. This document describes the radiologic approach to defining structural recurrent disease and the operative and nonoperative rationale in addressing identified structural disease to create equipoise in the personalized treatment strategy for the patient. The recommendations of this AHNS multidisciplinary consensus panel of the American Head and Neck Society are intended to help guide all multidisciplinary clinicians who diagnose or manage adult patients with thyroid cancer. The consensus panel is comprised of members of the American Head and Neck Society and its Endocrine Surgical Committee, and there is representation from medical endocrinology and both national and international surgical representation drawn from general/endocrine surgery and otolaryngology/head and neck surgery. Authors provided expertise for their respective sections, and consensus recommendations were made regarding the evaluation and treatment of recurrent thyroid cancer. Evidence-based literature support is drawn from thyroid cancer studies, recurrent thyroid cancer studies, and American Thyroid Association (ATA) guidelines. The manuscript was then distributed to members of the American Head and Neck Society Endocrine Committee and governing counsel for further feedback. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1862-1869, 2016.
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Affiliation(s)
| | - Michael Tuttle
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Richard Wong
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Drew Ridge
- Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Russell Smith
- University of Nebraska Medical Center, Omaha, Nebraska
| | - Dana Hartl
- Institut de Cancerologie Gustave Roussy, Villejuif, France
| | - Robert Levine
- Thyroid Center of New Hampshire, Nashua, New Hampshire
| | - Gregory Randolph
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
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