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Ultrasound-Guided Radiofrequency Ablation versus Reoperation for Level VI Lymph Nodes Recurrence After Thyroidectomy
Xiaoying Lin1, Lingpeng Tang1, Yuhan Xie1
1Shengli Clinical Medical College of Fujian Medical University, Fujian Medical University, Fuzhou 350001, China (X.L., L.T., Y.X., T.H., S.W.); Department of Ultrasonography, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350001, China (X.L., L.T., Y.X., T.H., S.W.).
Rationale And Objectives:
To compare the safety and efficacy of Ultrasound-Guided Radiofrequency Ablation (US-RFA) and reoperation in the management of level VI Lymph nodes (LNs) recurrence after thyroidectomy.
Methods:
A retrospective analysis was conducted on 74 patients who underwent treatment at Fujian Provincial Hospital between February 2019 and June 2022 for level VI LNs recurrence following thyroidectomy. All patients received either US-RFA or reoperation. The volume reduction rate (VRR) of level VI LNs was evaluated before and after US-RFA. The serum thyroglobulin (Tg) levels, recurrence and complication rates of level VI LNs were recorded and compared between the two groups. Disease progression was analyzed using Kaplan-Meier curves.
Results:
A total of 37 patients (mean age 48.86 ± 15.81; 25 females) in the US-RFA group and 37 patients (mean age 49.14 ± 15.76; 25 females) in the reoperation group were followed up. There were no statistically significant differences in recurrence-free survival of level VI LNs or Tg levels between the two groups (p > 0.05). The incidence rates of major and minor complications were comparable between the two groups (p > 0.05), but the overall complication rate was significantly higher in the reoperation group compared to the US-RFA group (p < 0.05). Additionally, US-RFA was related to less blood loss, smaller incisions, shorter procedure times, and a reduced length of hospitalization (all p < 0.001).
Conclusion:
US-RFA is as effective as reoperation for Level VI LNs recurrence after thyroidectomy, offering the advantages of being minimally invasive and associated with fewer complications.
