Ultrasound-guided Radiofrequency Ablation of Locally Recurrent Thyroid Carcinoma

Introduction:
Thyroid cancer typically has favorable outcomes with standard surgical therapy; however,  surgery  may  lead  to  several complications. Minimally invasive treatments such as radiofrequency ablation (RFA) has shown some promising signs in the management of these cases. We aimed to evaluate the feasibility, effectiveness, and safety of RFA for non-surgical treatment of benign loco-regional thyroid carcinomas, in both well-differentiated and medullary thyroid carcinomas (DTC and MTC) that are not amenable to traditional treatments.
Methods:
We conducted a retrospective review of 48 patients with 103 recurrent tumors (81 DTC, 22 MTC) who underwent RFA in our clinic. Patients were followed for 12 to 37 months to observe the outcomes and complications.
Results:
64 tumors (62.1%) completely disappeared at the last follow-up visit with 61 (59.2%) being resolved within 12 months. Therapeutic success (volume reduction ratio (VRR) >50%) was 96% (n=99) in all patients. The mean largest diameter of treated tumors decreased from 11.2 to 2.4 mm (p-value < 0.001) and the mean volume decreased from 501 to 41.6 mm3 at the last follow-up (mean VRR = 91%). We only observed one major and two minor complications (voice changes in DTC patients) that completely resolved during follow ups.
Conclusion:
RFA is a safe and effective alternative to repeat surgeries in recurrent loco-regional DTCs and MTCs. We recommend experienced interventional radiologists to consider RFA in MTC as well as DTCs.