Laser Ablation Treatment of Recurrent Lymph Node Metastases from Papillary Thyroid Carcinoma.
Laser Ablation Treatment of Recurrent Lymph Node Metastases from Papillary Thyroid Carcinoma.
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DOI：
10.3390/jcm10225295
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发表时间：
2021-11-14
影响因子：
3.9
通讯作者：
Spiezia S
中科院分区：
文献类型：
--
作者：
Offi C;Misso C;Antonelli G;Esposito MG;Brancaccio U;Spiezia S
(1)背景：甲状腺乳头状癌的发病率正在上升。乳头状肿瘤转移到颈部的中央和外侧淋巴结。复发率低于30%。治疗淋巴结复发的金标准是手术，但手术的并发症率很高。因此，复发性淋巴结的激光消融术已被公认为是一种微创、并发症率低、疗效好的替代治疗方法。(2)研究方法：我们分析了10名接受甲状腺全切除术和代谢放射治疗的患者，他们在接下来的12-18个月内发生了颈侧淋巴结复发。(3)结果：70%和30%的患者分别在IV和Vb水平发生淋巴结复发。所有患者均接受单次激光消融治疗。所有患者均行水分离术。在362 ± 45.7 s内输送的能量为1120 ± 159.3 J和3-4 W。未报告并发症。所有患者均接受了6个月的随访。在1个月、3个月和6个月随访时，报告的体积缩小分别为40.12 ± 2.2%、49.1 ± 2.13%和59.8 ± 3.05%。(4)结论：在6个月时，进行细针穿刺，结果为恶性细胞阴性，甲状腺球蛋白剂量为阴性。激光消融术是手术治疗的有效替代方法。
(1) Background: The incidence of papillary thyroid cancers is increasing. Papillary neoplasm metastasizes to the central and lateral lymph nodes of the neck. The recurrence rate is less than 30%. The gold standard of treatment for lymph node recurrences is surgery, but surgery is burdened by a high rate of complications. Therefore, laser ablation of recurrent lymph nodes has been recognized as an alternative treatment with minimal invasiveness, a low complication rate and a curative effect. (2) Methods: We analyzed 10 patients who underwent a total thyroidectomy and metabolic radiotherapy and who developed a lymph node recurrence in the laterocervical compartment in the following 12–18 months. (3) Results: Patients developed lymph node recurrence at IV and Vb levels in 70% and 30% of cases, respectively. All patients were treated with a single laser ablative session. Hydrodissection was performed in all patients. The energy delivered was 1120 ± 159.3 Joules and 3–4 Watts in 362 ± 45.7 s. No complications were reported. All patients underwent a 6-month follow-up. A volumetric reduction of 40.12 ± 2.2%, 49.1 ± 2.13% and 59.8 ± 3.05%, respectively at 1-, 3- and 6-months of follow-up was reported. (4) Conclusions: At 6 months, a fine needle aspiration was performed, which was negative for malignant cells and negative for a dosage of Thyroglobulin in eluate. The laser ablation is an effective alternative to surgical treatment.
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