Ethanol and thermal ablation for malignant thyroid tumours.

Area of Science:

• Oncology
• Radiology
• Surgical Oncology

Background:

• Papillary thyroid carcinoma (PTC) is the most prevalent thyroid malignancy with a generally favorable prognosis.
• While surgery is the standard treatment for primary and recurrent thyroid cancer, neck recurrence rates range from 20% to 59%.
• Ultrasound (US)-guided ablation techniques, such as ethanol ablation (EA) and thermal ablations, are viable alternatives for patients with contraindications to surgery.

Purpose of the Study:

• To comprehensively review the indications, devices, techniques, clinical outcomes, and complications of US-guided ethanol ablation (EA) and thermal ablations.
• To evaluate the efficacy and safety of US-guided ablation techniques for both primary and recurrent thyroid cancers.
• To synthesize available scientific evidence and expert opinions on the application of ablation therapies in thyroid cancer management.

Main Methods:

• Systematic review of scientific literature on US-guided ablation for thyroid cancer.
• Inclusion of expert opinions and clinical evidence regarding ethanol ablation (EA) and thermal ablation techniques.
• Evaluation of data pertaining to indications, procedural aspects, outcomes, and adverse events.

Main Results:

• US-guided ablation techniques, including EA and thermal ablations, are established alternatives for thyroid cancer when surgery is not feasible.
• These methods demonstrate varying degrees of efficacy and safety profiles for both primary and recurrent PTC.
• Specific indications, optimal techniques, and potential complications are detailed based on current evidence.

Conclusions:

• US-guided ethanol ablation (EA) and thermal ablations represent important minimally invasive treatment options for selected patients with primary or recurrent papillary thyroid carcinoma (PTC).
• Careful patient selection, appropriate technique, and awareness of potential complications are crucial for successful outcomes.
• Further research may refine the role and optimize the application of these ablation modalities in thyroid cancer therapy.