RECENT findings have suggested that image-guided thermal ablation is a safe and effective long-term treatment for papillary thyroid carcinoma (PTC), the most common form of thyroid cancer. This minimally invasive technique has gained traction as a viable alternative to traditional surgery, with the latest study providing a decade-long analysis of its outcomes.
The team highlighted the advantages of thermal ablation, noting its potential as an outpatient procedure with shorter treatment time, reduced need for general anaesthesia, and fewer complications compared to surgery. These benefits make thermal ablation an attractive option for patients with small, early-stage PTC (classified as T1N0M0), who would otherwise face the risks associated with thyroidectomy, the conventional approach.
Thermal ablation includes radiofrequency, microwave, and laser ablation, all of which are ultrasound-guided procedures that use heat to destroy cancer cells. While studies have demonstrated short-term success, long-term data has been limited until now. In response to this gap, the researchers conducted a retrospective study involving 179 patients with early-stage PTC treated across four university hospitals in China between June 2010 and March 2014. The average age of patients was 45.8, with women making up 65.9% of the sample.
Over a mean follow-up period of 10 years, the study observed a 10-year disease-free survival rate of 93.9%, with disease progression occurring in only 6.1% of patients. Specific findings included lymph node metastasis in 2.2% of cases and new tumour development in 3.3%. The technique was technically successful in all cases, achieving a median tumour volume reduction rate of 100% and a tumour disappearance rate of 97.2%.
The researchers concluded that thermal ablation represents a promising alternative for patients ineligible or unwilling to undergo surgery, though proper training in ultrasound and ablation techniques remains essential. This study reinforces the importance of skilled, experienced practitioners, with previous research suggesting a threshold of 50 successful ablation procedures as a marker of expertise.
While surgery remains the standard treatment for PTC, these findings mark a significant step forward in the availability of safe, effective, and less invasive options for thyroid cancer patients.
Reference
Yan L et al. Thermal ablation for papillary thyroid carcinoma. JAMA Otolaryngol Head Neck Surg. 2024;DOI:10.1001/jamaoto.2024.3229.
