Percutaneous Cryoablation of Papillary Thyroid Cancer

To investigate the safety and effectiveness of cryoablation in the treatment of papillary thyroid cancer (PTC).

During a period of 7 years, 71 PTCs in 65 patients treated with cryoablation were retrospectively reviewed. On ultrasound (US), the mean volume of the tumors was 6.9 mL; 35 tumors were T1, 29 were T2, and 7 were T3. Hydrodissection was performed medially and laterally in 36 patients, whereas in 29, a single or no hydrodissection was performed. After cryoablations, patients were followed up with 6 months intervals, and US findings were statistically compared.

Cryoablation was technically successful in all patients and tumors. Moderate adverse events occurred in 3% of the patients. Periprocedural hoarseness was significantly lower in patients who underwent medial and lateral hydrodissection (P < .001). The mean volume reductions at 6 months were 87.7% (SD ± 7.2) in T1 tumors and 85.4% (SD ± 6.3) in T1 + T2 tumors and did not differ statistically significantly (P = .36). During the 34.8-month mean follow-up, no local recurrence and no lymph node metastasis were seen.

Cryoablation is safe and effective in the treatment of PTCs. It may be a viable alternative to heat-based ablations and surgery particularly in T1b, T2, and T3 tumors. Both medial and lateral hydrodissections are recommended to prevent periprocedural hoarseness.