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Related Concept Videos

Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

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Thermal Ablation for Papillary Thyroid Carcinoma.

Lin Yan1, Yingying Li1, XinYang Li1

  • 1Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China.

JAMA Otolaryngology-- Head & Neck Surgery
|November 7, 2024
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Summary

Thermal ablation offers a safe and effective alternative for T1N0M0 papillary thyroid carcinoma (PTC) patients avoiding surgery. Ten-year outcomes show a 93.9% disease-free survival rate, demonstrating its long-term efficacy.

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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.