Ultrasound-Guided Ethanol Percutaneous Ablation Versus Rescue Surgery in Patients With Locoregional Recurrence of Papillary Thyroid Cancer.

IF 2.9 3区医学 Q1 OTORHINOLARYNGOLOGY

Clinical and Experimental Otorhinolaryngology Pub Date : 2023-11-01 Epub Date: 2023-08-23 DOI:10.21053/ceo.2023.00689

Santiago Tofé, Iñaki Argüelles, Cristina Álvarez, Álvaro Tofé, Alessandra Repetto, Antonia Barceló, Vicente Pereg

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引用次数: 0

Abstract

Objectives: Neck recurrence of papillary thyroid cancer (PTC) is frequently detected after initial surgery. The management of these lesions may include rescue surgery (RS) or minimally invasive techniques in selected patients, but comparative studies evaluating the effectiveness and safety of these techniques are lacking. In this paper, we compared ultrasound-guided ethanol ablation (EA) in selected patients to RS in a matched cohort.

Methods: We retrospectively compared 41 patients and 41 matched PTC patients without known distant metastases, who underwent ultrasound-guided EA or RS (matched reference group), who had 63 and 75 thyroid bed and/or lymph node confirmed PTC recurrences during a median follow-up of 72.8 and 89.6 months, respectively. The primary outcome was time until structural recurrence, compared using Kaplan-Meier survival curves. The secondary outcomes included time until biochemical recurrence, plasma thyroglobulin (Tg) levels, American Thyroid Association (ATA) response-to-therapy categories by the last available observation, and treatment-derived complications in each group.

Results: No significant differences were found between the EA and RS groups for time until structural recurrence (log-rank test, P=0.94). The time until biochemical recurrence was also similar (P=0.51); and the plasma Tg concentration reduction and proportions of patients in the ATA reclassification categories were also similar. A significantly higher proportion of patients in the RS group presented treatment-derived complications (29.27% vs. 9.75%, P<0.05).

Conclusion: In this retrospective analysis, the treatment of PTC neck recurrence with EA in selected patients was comparable to RS in a matched reference group for the long-term risk of structural or biochemical relapse, but with a lower risk of treatment-derived complications. These.

Results: support the effectiveness and safety of this minimally invasive technique in the management of selected patients with recurrent PTC.

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超声引导下乙醇经皮消融与抢救手术治疗甲状腺乳头状癌局部复发的比较。

目的:甲状腺乳头状癌(PTC)在初次手术后颈部复发是常见的。这些病变的处理可能包括抢救手术(RS)或对特定患者的微创技术，但缺乏评估这些技术有效性和安全性的比较研究。在本文中，我们比较了超声引导乙醇消融术(EA)在一个匹配的队列中选择的患者和RS。方法:我们回顾性比较41例患者和41例匹配的无远处转移的PTC患者，这些患者接受了超声引导的EA或RS(匹配参照组)，其中63例和75例甲状腺床和/或淋巴结确诊PTC复发，中位随访时间分别为72.8和89.6个月。使用Kaplan-Meier生存曲线进行比较，主要终点为结构性复发前的时间。次要结局包括到生化复发的时间，血浆甲状腺球蛋白(Tg)水平，美国甲状腺协会(ATA)对治疗的反应类别，以及每组治疗衍生的并发症。结果:EA组与RS组在结构复发时间上无显著差异(log-rank检验，P=0.94)。到生化复发的时间也相似(P=0.51);ATA重分类患者血浆Tg浓度降低及比例也相似。RS组患者出现治疗性并发症的比例显著高于RS组(29.27% vs. 9.75%)。结论:在本回顾性分析中，所选患者的EA治疗PTC颈部复发的长期结构性或生化复发风险与匹配参照组的RS相当，但治疗性并发症的风险较低。这些。结果:支持这种微创技术在治疗复发性PTC患者中的有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Otorhinolaryngology 医学-耳鼻喉科学

CiteScore

4.90

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.