{"title":"射频消融治疗危险三角区单发T1N0M0甲状腺乳头状癌:初步分析。","authors":"Dan-Ling Zhang, Sheng Chen, Yuhan Qiu, Jian-Chuan Yang, Zhiliang Hong, Jianwei Li, Song-Song Wu","doi":"10.1080/02656736.2024.2305256","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility, efficacy, and safety of radiofrequency ablation (RFA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) in the danger triangle area.</p><p><strong>Methods: </strong>94 participants (mean age 44.45 ± 13.08; 73 females) with solitary T1N0M0 PTC in the danger triangle area who underwent percutaneous RFA at the hospital from January 2018 to April 2020 were retrospectively analyzed. Key ablation procedures included sufficient paratracheal fluid isolation, low-power, and short active tip (5 mm working electrode). Tumor size changes at different time points after RFA, technical success rates, tumor disappearance, disease progression, and complications were recorded and compared.</p><p><strong>Results: </strong>Contrast-enhanced ultrasonography revealed that complete tumor ablation was performed with a 100% success rate in these patients. Post-ablation, the maximum diameter and volume of the ablation zone increased at the first and third month (<i>p</i> < 0.001), followed by a gradual decrease in size, without significant difference by the 6th month. The tumor disappearance rate was 76.59% (72/94), with higher rates in the T1a group compared to the T1b group (80% [64/80] VS57.1% [8/14], <i>p</i> < 0.001). There were no local recurrences. The incidence of new lesions and LNM was 3.2% (3/94), limited to the T1a subgroup. Further ablation was successfully applied to all new lesions and LMN. Mild voice changes were the only complication, with a rate of 3.2% (3/94), resolved within 4 months after RFA.</p><p><strong>Conclusions: </strong>Sufficient paratracheal fluid isolation combined with a low-power, short active tip radiofrequency ablation strategy is a safe and effective method for treating solitary T1N0M0 PTC in the danger triangle area.</p>","PeriodicalId":14137,"journal":{"name":"International Journal of Hyperthermia","volume":"41 1","pages":"2305256"},"PeriodicalIF":3.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Radiofrequency ablation for solitary T1N0M0 papillary thyroid carcinoma in the danger triangle area: a preliminary analysis.\",\"authors\":\"Dan-Ling Zhang, Sheng Chen, Yuhan Qiu, Jian-Chuan Yang, Zhiliang Hong, Jianwei Li, Song-Song Wu\",\"doi\":\"10.1080/02656736.2024.2305256\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate the feasibility, efficacy, and safety of radiofrequency ablation (RFA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) in the danger triangle area.</p><p><strong>Methods: </strong>94 participants (mean age 44.45 ± 13.08; 73 females) with solitary T1N0M0 PTC in the danger triangle area who underwent percutaneous RFA at the hospital from January 2018 to April 2020 were retrospectively analyzed. Key ablation procedures included sufficient paratracheal fluid isolation, low-power, and short active tip (5 mm working electrode). Tumor size changes at different time points after RFA, technical success rates, tumor disappearance, disease progression, and complications were recorded and compared.</p><p><strong>Results: </strong>Contrast-enhanced ultrasonography revealed that complete tumor ablation was performed with a 100% success rate in these patients. Post-ablation, the maximum diameter and volume of the ablation zone increased at the first and third month (<i>p</i> < 0.001), followed by a gradual decrease in size, without significant difference by the 6th month. The tumor disappearance rate was 76.59% (72/94), with higher rates in the T1a group compared to the T1b group (80% [64/80] VS57.1% [8/14], <i>p</i> < 0.001). There were no local recurrences. The incidence of new lesions and LNM was 3.2% (3/94), limited to the T1a subgroup. Further ablation was successfully applied to all new lesions and LMN. Mild voice changes were the only complication, with a rate of 3.2% (3/94), resolved within 4 months after RFA.</p><p><strong>Conclusions: </strong>Sufficient paratracheal fluid isolation combined with a low-power, short active tip radiofrequency ablation strategy is a safe and effective method for treating solitary T1N0M0 PTC in the danger triangle area.</p>\",\"PeriodicalId\":14137,\"journal\":{\"name\":\"International Journal of Hyperthermia\",\"volume\":\"41 1\",\"pages\":\"2305256\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Hyperthermia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02656736.2024.2305256\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Hyperthermia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02656736.2024.2305256","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的评估射频消融(RFA)治疗危险三角区单发T1N0M0甲状腺乳头状癌(PTC)的可行性、有效性和安全性。方法:回顾性分析2018年1月至2020年4月在该院接受经皮RFA治疗的危险三角区单发T1N0M0 PTC患者94例(平均年龄44.45±13.08;女性73例)。关键消融程序包括充分的气管旁液体隔离、低功率和短活动尖端(5 毫米工作电极)。记录并比较了RFA术后不同时间点的肿瘤大小变化、技术成功率、肿瘤消失、疾病进展和并发症:结果:对比增强超声波检查显示,这些患者的肿瘤完全消融成功率为 100%。消融术后,消融区的最大直径和体积在第一个月和第三个月有所增加(p p 结论):充分的气管旁液体隔离结合低功率、短主动脉尖射频消融策略是治疗危险三角区单发 T1N0M0 PTC 的一种安全有效的方法。
Radiofrequency ablation for solitary T1N0M0 papillary thyroid carcinoma in the danger triangle area: a preliminary analysis.
Objectives: To evaluate the feasibility, efficacy, and safety of radiofrequency ablation (RFA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) in the danger triangle area.
Methods: 94 participants (mean age 44.45 ± 13.08; 73 females) with solitary T1N0M0 PTC in the danger triangle area who underwent percutaneous RFA at the hospital from January 2018 to April 2020 were retrospectively analyzed. Key ablation procedures included sufficient paratracheal fluid isolation, low-power, and short active tip (5 mm working electrode). Tumor size changes at different time points after RFA, technical success rates, tumor disappearance, disease progression, and complications were recorded and compared.
Results: Contrast-enhanced ultrasonography revealed that complete tumor ablation was performed with a 100% success rate in these patients. Post-ablation, the maximum diameter and volume of the ablation zone increased at the first and third month (p < 0.001), followed by a gradual decrease in size, without significant difference by the 6th month. The tumor disappearance rate was 76.59% (72/94), with higher rates in the T1a group compared to the T1b group (80% [64/80] VS57.1% [8/14], p < 0.001). There were no local recurrences. The incidence of new lesions and LNM was 3.2% (3/94), limited to the T1a subgroup. Further ablation was successfully applied to all new lesions and LMN. Mild voice changes were the only complication, with a rate of 3.2% (3/94), resolved within 4 months after RFA.
Conclusions: Sufficient paratracheal fluid isolation combined with a low-power, short active tip radiofrequency ablation strategy is a safe and effective method for treating solitary T1N0M0 PTC in the danger triangle area.