Differences in treatment outcomes between ultrasound-guided percutaneous microwave ablation and endoscopic thyroidectomy for patients with papillary thyroid microcarcinoma

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Abstract

Background:

The differences in treatment outcomes between ultrasound (US)-guided percutaneous microwave ablation (PMWA) and endoscopic thyroidectomy for patients with papillary thyroid microcarcinoma (PTMC) remains unknown.

Methods:

An electronic search will be performed for randomized controlled trials or observational studies that reported recurrence and mortality rates in PTMC patients with US-guided PMWA or endoscopic thyroidectomy. Hazard ratios with their 95% confidence intervals will be calculated using fixed- or random-effects models according to heterogeneity.

Results:

This study will present the differences in treatment outcomes between US-guided PMWA and endoscopic thyroidectomy for patients with PTMC by pooling the results of individual studies.

Conclusion:

The results of this study would provide vigorous evidence in this issue and offer the guidance to both clinical decision-making and future research.

Ethics and dissemination:

Ethical approval is not applicable for this study.

PROSPERO registration number:

CRD42018112320.

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Most cited references 9

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Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study.

So-Lyung Jung, D. Kim, Sun I l Kim … (2011)

To evaluate clinical aspects and imaging features of complications encountered in the treatment of benign thyroid nodules with radiofrequency (RF) ablation. Institutional review board approval was obtained for this retrospective study, and informed consent was waived. From June 2002 to September 2009, 1459 patients underwent RF ablation of 1543 thyroid nodules with an RF system with internally cooled electrodes at 13 thyroid centers, which were members of Korean Society of Thyroid Radiology. Numbers and types of major and minor complications were assessed. The authors observed 48 complications (3.3%), 20 major and 28 minor. The major complications were voice changes (n = 15), brachial plexus injury (n = 1), tumor rupture (n = 3), and permanent hypothyroidism (n = 1). The minor complications were hematoma (n = 15), skin burn (n = 4), and vomiting (n = 9). All patients recovered spontaneously except for one with permanent hypothyroidism and one who underwent surgery. Although the complication rate of RF ablation is low, various complications may occur; comprehension of complications and suggested technical tips may prevent complications or properly manage those that occur. © RSNA, 2011.

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Overdiagnosis and overtreatment of thyroid cancer: A population-based temporal trend study

Sabrina Jegerlehner, Jean-Luc Bulliard, Drahomir Aujesky … (2017)

Background The increase in incidence of thyroid cancer during the last decades without concomitant rise in mortality may reflect the growing detection of indolent forms of thyroid cancer, and may have fueled unnecessary thyroidectomies. Our aim was therefore, to compare recent secular trends in surgical intervention rate for thyroid cancer with the incidence and mortality of thyroid cancer to assess overdiagnosis and resulting overtreatment. Methods We conducted a population-based temporal trend study in Switzerland from 1998 to 2012. All cases of invasive thyroid cancer, deaths from thyroid cancer, and cancer-related thyroidectomies were analyzed. We calculated changes in age-standardized thyroid cancer incidence rates, stratified by histologic subtype and tumor stage, thyroid cancer-specific mortality, and thyroidectomy rates. Results Between 1998 and 2012, the age-standardized annual incidence of thyroid cancer increased from 5.9 to 11.7 cases/100,000 among women (annual mean absolute increase: +0.43/100,000/year) and from 2.7 to 3.9 cases/100,000 among men (+0.11/100,000/year). The increase was limited to the papillary subtype, the most indolent form of thyroid cancer. The incidence of early stages increased sharply, the incidence of advanced stages increased marginally, and the mortality from thyroid cancer decreased slightly. There was a three- to four-fold increase in the age-standardized annual thyroidectomy rate in both sexes. Conclusions We observed a large increase in the incidence of thyroid cancer, limited to papillary and early stage tumors, with a three- to four-fold parallel increase in thyroidectomy. The mortality slightly decreased. These findings suggest that a substantial and growing part of the detected thyroid cancers are overdiagnosed and overtreated. Impact Targeted screening and diagnostic strategies are warranted to avoid overdetection and unnecessary treatment of thyroid cancers.

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Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients.

Wenwen Yue, Shurong Wang, Bin Wang … (2013)

Microwave ablation is a minimally invasive technique that has been used to treat benign and malignant tumors of liver, lung and kidney. Towards thyroid nodules, only a few cases are reported so far. The aim of the study was to investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules with a large sample. A total of 477 benign thyroid nodules in 222 patients underwent microwave ablation in our department from July 2009 to March 2012. Microwave ablation was carried out using microwave antenna (16G) under local anesthesia. Nodule volume, thyroid function and clinical symptoms were evaluated before treatment and at 1, 3, more than 6 months. The study was ethics committee approved and written informed consents were obtained from all patients. All thyroid nodules significantly decreased in size after microwave ablation. A 6-month follow-up was achieved in 254 of 477 nodules, and the mean decrease in the volume of thyroid nodules was from 2.13 ± 4.42 ml to 0.45 ± 0.90 ml, with a mean percent decrease of 0.65 ± 0.65. A volume-reduction ratio greater than 50% was observed in 82.3% (209/254) of index nodules, and 30.7% (78/254) of index nodules disappeared 6-month after the ablation. The treatment was well tolerated and no major complications were observed except pain and transient voice changes. Microwave ablation seems to be a safe and effective technique for the treatment of benign thyroid nodules. Further prospective randomized studies are needed to define the role of the procedure in the treatment of thyroid nodules. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: January 2019

Publication date (Electronic): 04 January 2019

Volume: 98

Issue: 1

Electronic Location Identifier: e13953

Affiliations

[a ]Department of Medical Ultrasound

[b ]Department of Pathology

[c ]Department of Surgery, Gong Li Hospital, Pudong New Area, Shanghai, China.

Author notes

[∗ ]Correspondence: Xiao-Hong Fu, Department of Medical Ultrasound, Gong Li Hosptial, Shanghai, 200135, China (e-mail: fuxiaohong66@ 123456126.com ); Xiao-Yan Cai, Department of Surgery, Gong Li Hospital, Pudong New Area, Shanghai 200135, China (e-mail: caixiaoyan666@ 123456126.com ).

Article

Publisher ID: MD-D-18-09173 Accession ID: 13953

DOI: 10.1097/MD.0000000000013953

PMC ID: 6344203

PubMed ID: 30608430

SO-VID: 682924da-955e-4558-834d-5bf70a58fa7e

License:

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

History

Date received : 7 December 2018

Date accepted : 11 December 2018

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Keywords: endoscopic thyroidectomy,meta-analysis,mortality rates,papillary thyroid microcarcinoma,ultrasound-guided percutaneous microwave ablation

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Keywords: endoscopic thyroidectomy, meta-analysis, mortality rates, papillary thyroid microcarcinoma, ultrasound-guided percutaneous microwave ablation

Differences in treatment outcomes between ultrasound-guided percutaneous microwave ablation and endoscopic thyroidectomy for patients with papillary thyroid microcarcinoma : Protocol for a systematic review and meta-analysis

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Most cited references 9

Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study.

Overdiagnosis and overtreatment of thyroid cancer: A population-based temporal trend study

Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: safety and imaging follow-up in 222 patients.

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