US-guided Microwave Ablation of Low-Risk Papillary Thyroid Microcarcinoma: Longer-Term Results of a Prospective Study
US-guided Microwave Ablation of Low-Risk Papillary Thyroid Microcarcinoma: Longer-Term Results of a Prospective Study
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超声引导下微波消融治疗低风险甲状腺微小乳头状癌：前瞻性研究的长期结果
DOI：
10.1210/clinem/dgaa128
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发表时间：
2020-06-01
影响因子：
5.8
通讯作者：
Wang, Shu-Rong
中科院分区：
文献类型：
--
作者：
Yue, Wen-Wen;Qi, Lu;Wang, Shu-Rong
背景：甲状腺微小乳头状癌（PTMC）已成为甲状腺癌高发的主要原因。本研究的目的是评估超声（US）引导下微波消融（MWA）治疗低风险PTMC与大population.Methods的长期有效性：这项前瞻性研究是由伦理委员会的批准，我们的机构。在超声引导下对119例无临床颈部或远处转移的单灶性PTMC患者进行MWA。超声造影判断靶区超出肿瘤边缘，避免边缘残留和复发。在治疗后1、3、6和12个月随访超声和甲状腺功能评估，此后每6至12个月随访一次。结果：MWA后随访时间为37.2 ± 20.9个月（范围12-101个月）。肿瘤体积从MWA后即刻的1.87 ± 1.03 mL显著下降至最终评估时的0.01 ± 0.04 mL（P < 0.001），平均体积缩小率为99.4 ± 2.2%，107例（93.9%）获得完全缓解。1例患者在26个月随访时检测到颈部淋巴结转移，并成功接受了1次额外MWA治疗。无远处转移。所有获得的组织病理学结果证实MWA后没有残留或复发的肿瘤细胞。所有patients.Conclusions：经皮MWA是完全PTMC破坏技术上可行的，并显示出良好的长期有效性，因此，它似乎是一种有效的非手术治疗，以补充目前的建议，为选定的低风险PTMC患者。
Background: Papillary thyroid microcarcinoma (PTMC) has become a main cause of the extremely high incidence of thyroid carcinoma. This study aimed to evaluate the longer-term effectiveness of ultrasound (US)-guided microwave ablation (MWA) for treatment of low-risk PTMC with a large population.Methods: This prospective study was approved by ethics committee of our institution. MWA was performed under US-guidance for 119 unifocal PTMC patients without clinically cervical or distant metastasis. The target ablation zone exceeded the tumor edge judged by contrast-enhanced US to avoid marginal residue and recurrence. US and thyroid function evaluation were followed at 1, 3, 6, and 12 months after treatment and every 6 to 12 months thereafter. Any adverse event associated with MWA was evaluated.Results: The follow-up duration after MWA was 37.2 +/- 20.9 months (range 12-101 months). Tumor volume decreased significantly from 1.87 +/- 1.03 mL immediately after MWA to 0.01 +/- 0.04 mL at the final evaluation (P < 0.001), with a mean volume reduction ratio of 99.4 +/- 2.2% and 107 cases (93.9%) got complete remission. A patient was detected with cervical lymph node metastasis at 26-month follow-up and underwent 1 additional MWA treatment successfully. No distant metastasis was observed. All the acquired histological pathology results confirmed the absence of residual or recurrent tumor cells after MWA. No delayed complications associated with MWA were encountered for all patients.Conclusions: Percutaneous MWA is technically feasible for complete PTMC destruction and showed well longer-term effectiveness; thus, it seems to be an effective nonsurgical therapy to complement the current recommendation for selected low-risk PTMC patients.