Context: Percutaneous laser ablation (PLA) may be useful in treating patients with metachronous metastatic lymph nodes in the neck. Objective: Our objective was to assess PLA as a treatment of difficult-to-treat metachronous cervical lymph node metastases from papillary thyroid carcinoma. Design and Setting: We conducted a retrospective analysis of prospectively collected data at a public hospital. Patients: Fifteen patients with previous resection of papillary thyroid carcinoma with elevated serum levels of thyroglobulin (Tg) or anti-Tg antibodies (TgAbs) and 24 metachronous nodal metastases treated between September 2010 and April 2012 were followed with [18F] fluorodeoxyglucose (18FDG) positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced ultrasound (CEUS). Intervention: Intervention was PLA. Outcome Measures: Technique feasibility and technical success were evaluated. Tg/TgAb serum levels and 18FDG-PET/ CT, and CEUS appearance were assessed at 6 and 12 months and compared with baseline. Complications were recorded. Results: PLA was always feasible, and technical success was achieved in all patients. At 6 months, local control was achieved in 11 of 15 patients (73%), with 6 (40%) having serum Tg/TgAb normalized (P = .017 vs baseline). Whereas 20 of 24 (83%) nodes were negative at 18FDG-PET/CT and CEUS (P < .001 vs baseline), 4 were 18FDG-PET/CT-positive (3 also CEUS-positive). At the 12-month follow-up, local control was achieved in 10 of 14 patients (71.4%). Sixteen of 20 nodes (80%) were negative at 18FDG-PET/CT and CEUS (P < .001 vs baseline), 4 were 18FDG-PET/CT-positive (2 also CEUS-positive). Four of 10 (40%) patients had normalization of serum Tg/TgAb (P = .098 vs baseline). No major complications occurred. Conclusions: PLA is potentially feasible, safe, and effective for the treatment of metachronous cervical nodal metastases from papillary thyroid carcinoma. This procedure may reduce or delay a large number of highly invasive repeat neck dissections.

Percutaneous laser ablation of metastatic lymph nodes in the neck from papillary thyroid carcinoma: Preliminary results / G. Mauri, L. Cova, T. Tondolo, T. Ierace, A. Baroli, E. Di Mauro, C.M. Pacella, S.N. Goldberg, L. Solbiati. - In: THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM. - ISSN 0021-972X. - 98:7(2013), pp. E1203-E1207.

Percutaneous laser ablation of metastatic lymph nodes in the neck from papillary thyroid carcinoma: Preliminary results

G. Mauri;T. Tondolo;A. Baroli;
2013

Abstract

Context: Percutaneous laser ablation (PLA) may be useful in treating patients with metachronous metastatic lymph nodes in the neck. Objective: Our objective was to assess PLA as a treatment of difficult-to-treat metachronous cervical lymph node metastases from papillary thyroid carcinoma. Design and Setting: We conducted a retrospective analysis of prospectively collected data at a public hospital. Patients: Fifteen patients with previous resection of papillary thyroid carcinoma with elevated serum levels of thyroglobulin (Tg) or anti-Tg antibodies (TgAbs) and 24 metachronous nodal metastases treated between September 2010 and April 2012 were followed with [18F] fluorodeoxyglucose (18FDG) positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced ultrasound (CEUS). Intervention: Intervention was PLA. Outcome Measures: Technique feasibility and technical success were evaluated. Tg/TgAb serum levels and 18FDG-PET/ CT, and CEUS appearance were assessed at 6 and 12 months and compared with baseline. Complications were recorded. Results: PLA was always feasible, and technical success was achieved in all patients. At 6 months, local control was achieved in 11 of 15 patients (73%), with 6 (40%) having serum Tg/TgAb normalized (P = .017 vs baseline). Whereas 20 of 24 (83%) nodes were negative at 18FDG-PET/CT and CEUS (P < .001 vs baseline), 4 were 18FDG-PET/CT-positive (3 also CEUS-positive). At the 12-month follow-up, local control was achieved in 10 of 14 patients (71.4%). Sixteen of 20 nodes (80%) were negative at 18FDG-PET/CT and CEUS (P < .001 vs baseline), 4 were 18FDG-PET/CT-positive (2 also CEUS-positive). Four of 10 (40%) patients had normalization of serum Tg/TgAb (P = .098 vs baseline). No major complications occurred. Conclusions: PLA is potentially feasible, safe, and effective for the treatment of metachronous cervical nodal metastases from papillary thyroid carcinoma. This procedure may reduce or delay a large number of highly invasive repeat neck dissections.
ultrasound; criteria; tissue; tumors
Settore MED/36 - Diagnostica per Immagini e Radioterapia
2013
Article (author)
File in questo prodotto:
File Dimensione Formato  
jcem1203.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 634.76 kB
Formato Adobe PDF
634.76 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/733343
Citazioni
  • ???jsp.display-item.citation.pmc??? 18
  • Scopus 73
  • ???jsp.display-item.citation.isi??? 66
social impact