Thermal Ablation for Papillary Thyroid Carcinoma

Area of Science:

• Oncology
• Minimally Invasive Surgery
• Radiology

Background:

• Papillary thyroid carcinoma (PTC) T1N0M0 is often indolent.
• Image-guided thermal ablation is an alternative to surgery or active surveillance for select PTC patients.
• Long-term outcomes of thermal ablation for PTC are needed.

Purpose of the Study:

• To investigate the 10-year outcomes of thermal ablation for T1N0M0 papillary thyroid carcinoma.
• To evaluate the safety and efficacy of thermal ablation as a treatment for early-stage PTC.

Main Methods:

• A multicenter cohort study included 179 patients with T1N0M0 PTC treated with thermal ablation between 2010 and 2014.
• Patients had tumors <20mm, with no evidence of lymph node metastasis or distant spread.
• Disease progression and disease-free survival (DFS) were primary outcomes, assessed over a mean follow-up of 120.8 months.

Main Results:

• The 10-year disease-free survival rate was 93.9%.
• Disease progression occurred in 6.1% of patients (lymph node metastasis, new or persistent tumors).
• Technical success was 100%, with a 97.2% tumor disappearance rate and minimal complications (0.6% transient voice hoarseness).

Conclusions:

• Thermal ablation is a safe and effective alternative for T1N0M0 PTC patients who opt against surgery or active surveillance.
• Accurate imaging, understanding of ablation techniques, and experienced physicians are crucial for successful outcomes.
• The study supports thermal ablation as a viable long-term treatment option for selected early-stage papillary thyroid cancer.