Skip to main content
Erschienen in: Endocrine 3/2018

13.08.2018 | Original Article

Safety and efficiency of ultrasound-guided low power microwave ablation in the treatment of cervical metastatic lymph node from papillary thyroid carcinoma: a mean of 32 months follow-up study

verfasst von: Dengke Teng, Lei Ding, Yu Wang, Caimei Liu, Yongxu Xia, Hui Wang

Erschienen in: Endocrine | Ausgabe 3/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the safety and efficiency of microwave ablation (MWA) with low power of 20 w, respectively, in the treatment of cervical metastatic lymph node (CMLN) from papillary thyroid carcinoma (PTC) with a mean of 32-month follow-up.

Methods

Eleven patients in total with 24 cervical lymph nodes (LNs) diagnosed with CMLN from PTC underwent MWA at a power of 20 w. We recorded images of the LNs under ultrasound first before MWA and 1, 3, 6, 12, months after MWA, and then every 6 months, respectively. The volumes of the LNs were compared before MWA and at each follow-up point after MWA. The thyroglobulin (Tg) test was performed before MWA and 3 months after MWA.

Results

All patients were successfully treated, and they showed no major complications. Before MWA, the mean volume of the LNs was 364.15 ± 306.89 mm3, which decreased to 234.10 ± 230.34 mm3, 107.51 ± 129.47 mm3, 20.88 ± 39.27 mm3, 3.38 ± 12.74 mm3, and completely disappeared at the follow-up point of 1, 3, 6, 12, and 18 months after MWA, respectively. The mean Tg was 11.81 ± 7.50 ng/ml, a data significantly decreased to 0.43 ± 0.11 ng/ml 3 months after MWA (P = 0.000). In the follow-up period, no recurrent lesions were found.

Conclusions

For the treatment of CMLN from PTC, low power MWA showed good safety and efficacy. MWA is likely to be a candidate for patients with high risks or who refuse reoperation.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
5.
Zurück zum Zitat I.D. Hay, G.B. Thompson, C.S. Grant, E.J. Bergstralh, C.E. Dvorak, C.A. Gorman, M.S. Maurer, B. McIver, B.P. Mullan, A.L. Oberg, C.C. Powell, J.A. van Heerden, J.R. Goellner, Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940-1999): temporal trends in initial therapy and long-term outcome in 2444 consecutively treated patients. World J. Surg. 26(8), 879–885 (2002). https://doi.org/10.1007/s00268-002-6612-1. 2.523CrossRefPubMed I.D. Hay, G.B. Thompson, C.S. Grant, E.J. Bergstralh, C.E. Dvorak, C.A. Gorman, M.S. Maurer, B. McIver, B.P. Mullan, A.L. Oberg, C.C. Powell, J.A. van Heerden, J.R. Goellner, Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940-1999): temporal trends in initial therapy and long-term outcome in 2444 consecutively treated patients. World J. Surg. 26(8), 879–885 (2002). https://​doi.​org/​10.​1007/​s00268-002-6612-1. 2.523CrossRefPubMed
17.
Zurück zum Zitat A. Heilo, E. Sigstad, K.H. Fagerlid, O.I. Haskjold, K.K. Groholt, A. Berner, T. Bjoro, L.H. Jorgensen, Efficacy of ultrasound-guided percutaneous ethanol injection treatment in patients with a limited number of metastatic cervical lymph nodes from papillary thyroid carcinoma. J. Clin. Endocrinol. Metab. 96(9), 2750–2755 (2011). https://doi.org/10.1210/jc.2010-2952 CrossRefPubMed A. Heilo, E. Sigstad, K.H. Fagerlid, O.I. Haskjold, K.K. Groholt, A. Berner, T. Bjoro, L.H. Jorgensen, Efficacy of ultrasound-guided percutaneous ethanol injection treatment in patients with a limited number of metastatic cervical lymph nodes from papillary thyroid carcinoma. J. Clin. Endocrinol. Metab. 96(9), 2750–2755 (2011). https://​doi.​org/​10.​1210/​jc.​2010-2952 CrossRefPubMed
19.
Zurück zum Zitat I.D. Hay, R.A. Lee, C. Davidge-Pitts, C.C. Reading, J.W. Charboneau, Long-term outcome of ultrasound-guided percutaneous ethanol ablation of selected “recurrent” neck nodal metastases in 25 patients with TNM stages III or IVA papillary thyroid carcinoma previously treated by surgery and 131I therapy. Surgery 154(6), 1448–1454 (2013). https://doi.org/10.1016/j.surg.2013.07.007 CrossRefPubMed I.D. Hay, R.A. Lee, C. Davidge-Pitts, C.C. Reading, J.W. Charboneau, Long-term outcome of ultrasound-guided percutaneous ethanol ablation of selected “recurrent” neck nodal metastases in 25 patients with TNM stages III or IVA papillary thyroid carcinoma previously treated by surgery and 131I therapy. Surgery 154(6), 1448–1454 (2013). https://​doi.​org/​10.​1016/​j.​surg.​2013.​07.​007 CrossRefPubMed
25.
Zurück zum Zitat J.H. Kim, W.S. Yoo, Y.J. Park, D.J. Park, T.J. Yun, S.H. Choi, C.H. Sohn, K.E. Lee, M.W. Sung, Y.K. Youn, K.H. Kim, B.Y. Cho, Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology 276(3), 909–918 (2015). https://doi.org/10.1148/radiol.15140079. 6.798CrossRefPubMed J.H. Kim, W.S. Yoo, Y.J. Park, D.J. Park, T.J. Yun, S.H. Choi, C.H. Sohn, K.E. Lee, M.W. Sung, Y.K. Youn, K.H. Kim, B.Y. Cho, Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology 276(3), 909–918 (2015). https://​doi.​org/​10.​1148/​radiol.​15140079. 6.798CrossRefPubMed
27.
28.
Zurück zum Zitat G. Mauri, L. Cova, T. Tondolo, T. Ierace, A. Baroli, E. Di Mauro, C.M. Pacella, S.N. Goldberg, L. Solbiati, Percutaneous laser ablation of metastatic lymph nodes in the neck from papillary thyroid carcinoma: preliminary results. J. Clin. Endocrinol. Metab. 98(7), E1203–1207 (2013). https://doi.org/10.1210/jc.2013-1140 CrossRefPubMed G. Mauri, L. Cova, T. Tondolo, T. Ierace, A. Baroli, E. Di Mauro, C.M. Pacella, S.N. Goldberg, L. Solbiati, Percutaneous laser ablation of metastatic lymph nodes in the neck from papillary thyroid carcinoma: preliminary results. J. Clin. Endocrinol. Metab. 98(7), E1203–1207 (2013). https://​doi.​org/​10.​1210/​jc.​2013-1140 CrossRefPubMed
29.
Zurück zum Zitat E. Papini, G. Bizzarri, A. Bianchini, D. Valle, I. Misischi, R. Guglielmi, M. Salvatori, L. Solbiati, A. Crescenzi, C.M. Pacella, H. Gharib, Percutaneous ultrasound-guided laser ablation is effective for treating selected nodal metastases in papillary thyroid cancer. J. Clin. Endocrinol. Metab. 98(1), E92–97 (2013). https://doi.org/10.1210/jc.2012-2991 CrossRefPubMed E. Papini, G. Bizzarri, A. Bianchini, D. Valle, I. Misischi, R. Guglielmi, M. Salvatori, L. Solbiati, A. Crescenzi, C.M. Pacella, H. Gharib, Percutaneous ultrasound-guided laser ablation is effective for treating selected nodal metastases in papillary thyroid cancer. J. Clin. Endocrinol. Metab. 98(1), E92–97 (2013). https://​doi.​org/​10.​1210/​jc.​2012-2991 CrossRefPubMed
30.
Zurück zum Zitat G. Mauri, L. Cova, T. Ierace, A. Baroli, E. Di Mauro, C.M. Pacella, S.N. Goldberg, L. Solbiati, Treatment of metastatic lymph nodes in the neck from papillary thyroid carcinoma with percutaneous laser ablation. Cardiovasc. Interv. Radiol. 39(7), 1023–1030 (2016). https://doi.org/10.1007/s00270-016-1313-6 CrossRef G. Mauri, L. Cova, T. Ierace, A. Baroli, E. Di Mauro, C.M. Pacella, S.N. Goldberg, L. Solbiati, Treatment of metastatic lymph nodes in the neck from papillary thyroid carcinoma with percutaneous laser ablation. Cardiovasc. Interv. Radiol. 39(7), 1023–1030 (2016). https://​doi.​org/​10.​1007/​s00270-016-1313-6 CrossRef
32.
Zurück zum Zitat B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M. Sawka, M. Schlumberger, K.G. Schuff, S.I. Sherman, J.A. Sosa, D.L. Steward, R.M. Tuttle, L. Wartofsky, 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1), 1–133 (2016). https://doi.org/10.1089/thy.2015.0020. 3.784CrossRefPubMedPubMedCentral B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M. Sawka, M. Schlumberger, K.G. Schuff, S.I. Sherman, J.A. Sosa, D.L. Steward, R.M. Tuttle, L. Wartofsky, 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26(1), 1–133 (2016). https://​doi.​org/​10.​1089/​thy.​2015.​0020. 3.784CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat W. Shady, E.N. Petre, K.G. Do, M. Gonen, H. Yarmohammadi, K.T. Brown, N.E. Kemeny, M. D’Angelica, P.T. Kingham, S.B. Solomon, C.T. Sofocleous, Percutaneous microwave versus radiofrequency ablation of colorectal liver metastases: ablation with clear margins (A0) provides the best local tumor control. J. Vasc. Interv. Radiol. 29(2), 268–275.e261 (2018). https://doi.org/10.1016/j.jvir.2017.08.021. 2.57CrossRefPubMed W. Shady, E.N. Petre, K.G. Do, M. Gonen, H. Yarmohammadi, K.T. Brown, N.E. Kemeny, M. D’Angelica, P.T. Kingham, S.B. Solomon, C.T. Sofocleous, Percutaneous microwave versus radiofrequency ablation of colorectal liver metastases: ablation with clear margins (A0) provides the best local tumor control. J. Vasc. Interv. Radiol. 29(2), 268–275.e261 (2018). https://​doi.​org/​10.​1016/​j.​jvir.​2017.​08.​021. 2.57CrossRefPubMed
Metadaten
Titel
Safety and efficiency of ultrasound-guided low power microwave ablation in the treatment of cervical metastatic lymph node from papillary thyroid carcinoma: a mean of 32 months follow-up study
verfasst von
Dengke Teng
Lei Ding
Yu Wang
Caimei Liu
Yongxu Xia
Hui Wang
Publikationsdatum
13.08.2018
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 3/2018
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-018-1711-4

Weitere Artikel der Ausgabe 3/2018

Endocrine 3/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.