Efficacy and Safety of Radiofrequency Ablation for Treatment of Locally Recurrent Thyroid Cancers Smaller than 2 cm
Efficacy and Safety of Radiofrequency Ablation for Treatment of Locally Recurrent Thyroid Cancers Smaller than 2 cm
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DOI：
10.1148/radiol.15140079
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发表时间：
2015-09-01
期刊：
影响因子：
19.7
通讯作者：
Cho, Bo Youn
中科院分区：
文献类型：
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作者：
Kim, Ji-hoon;Yoo, Won Sang;Cho, Bo Youn
目的：通过与重复手术进行比较，评估射频消融（RFA）治疗小于 2 cm 的局限性小复发性甲状腺癌的疗效和安全性。 材料和方法：这项回顾性研究经机构审查委员会批准，并放弃知情同意。从 2008 年 12 月到 2011 年 12 月，本研究评估了 73 名复发性甲状腺癌患者（17 名男性和 56 名女性；年龄，50.3 岁 +/- 13.6），这些患者曾接受 RFA 治疗（n = 27）或重复手术（n = 46），这些患者符合以下标准： (b) 除目标肿瘤外没有其他肿瘤； (c) 至少一年的随访。 RFA被推荐在不适合手术的情况下进行，例如患者拒绝和医疗状况不佳。使用治疗权重逆概率进行加权分析调整后，比较 RFA 组和再手术组的无复发生存率和治疗后并发症发生率（例如声音嘶哑和低钙血症）。结果：调整后，RFA 组（分别为 96.0% 和 92.6%）和再手术组（分别为 96.0% 和 92.6%）和 3 年无复发生存率具有可比性（P = 0.681）。分别为 92.2%）组。 RFA 组（7.3% [24 中的 1.8]）和再次手术组（9.0% [39.5 中的 3.6]）治疗后声音嘶哑率没有差异（P = 0.812），并且治疗后低钙血症仅发生在再手术组（11.6% [39.5 中的 4.6]），但 RFA 组中没有发生（0% [24 中的 0]）（P = .083).结论：对于局部复发性小甲状腺癌患者，RFA 可能是重复手术的有效且安全的替代方案。 (C) 北美放射学会，2015
Purpose: To evaluate the efficacy and safety of radiofrequency ablation (RFA) for localized small recurrent thyroid cancers less than 2 cm by comparing them with those at repeat surgery.Materials and Methods: This retrospective study was institutional review board-approved, and informed consent was waived. From December 2008 to December 2011, this study evaluated 73 patients (17 men and 56 women; age, 50.3 years +/- 13.6) with recurrent thyroid cancer who had been treated with RFA (n = 27) or repeat surgery (n = 46) who met the following criteria: (a) three or fewer recurrences or lesions with high probability of recurrence at ultrasonography; (b) no tumor other than the target tumors; and (c) at least 1 year of follow-up. RFA was recommended and performed in cases of surgical ineligibility, such as patient refusal and poor medical condition. Recurrence-free survival rates and posttreatment complication rates (eg, hoarseness and hypocalcemia) were compared between RFA and reoperation groups after adjustment with weighted analysis by using inverse probability of treatment weights.Results: After this adjustment, the 1- and 3-year recurrence-free survival rates were comparable (P = .681) for RFA (96.0% and 92.6%, respectively) and reoperation (92.2% and 92.2%, respectively) groups. The posttreatment hoarseness rate did not differ between the RFA (7.3% [1.8 of 24]) and reoperation (9.0% [3.6 of 39.5]) groups (P = .812), and posttreatment hypocalcemia occurred exclusively in the reoperation group (11.6% [4.6 of 39.5]) but not in the RFA group (0% [0 of 24]) (P = .083).Conclusion: RFA may be an effective and safe alternative to repeat surgery in patients with locally recurrent small thyroid cancers. (C) RSNA, 2015