Thyroid : official journal of the American Thyroid Association | 2019
Thermal ablation for Small Papillary Thyroid Cancer: A Systematic Review.
Abstract
BACKGROUND\nAlthough clinical studies indicate that thermal ablation is effective in treating low-risk papillary thyroid microcarcinomas (PTMCs), the effectiveness of this treatment in patients with low-risk PTMC has not yet been systematically evaluated.\n\n\nMETHODS\nOvid-MEDLINE and EMBASE databases were searched for studies published through May 1, 2019, reporting the efficacy of thermal ablation in patients with low-risk PTMC. Data were extracted and methodological quality assessed independently by two radiologists according to PRISMA guidelines.\n\n\nRESULTS\nThis systematic review identified 503 low-risk PTMCs in 470 patients treated by thermal ablation from 9 studies. During follow-up, no patient experienced local tumor recurrence or distant metastasis, whereas two patients (0.4%) experienced lymph node metastasis. One patient (0.2%) developed a new PTMC, which was successfully treated by additional ablation. Five patients (1.1%) underwent delayed surgery after ablation, including the two patients with lymph node metastasis and three additional patients with unknown etiology.\n\n\nCONCLUSIONS\nThermal ablation is an excellent local tumor control method in patients with low-risk PTMCs. Strict inclusion criteria and technical expertise are required to obtain favorable results.