Abstract
ObjectiveTo evaluate the safety and efficacy of radiofrequency ablation (RFA) for metastatic lymph nodes (LNs) in children and adolescents with papillary Thyroid Carcinoma (PTC).Materials and MethodsFrom December 2014 to March 2018, 10 metastatic LNs(mean volume 0.30 ± 0.38 ml, range 0.06-1.23ml) in 5 children and adolescents (3 females, 2 males; mean age 15.60 ± 2.97 years, range 12-19 years) with PTC treated by RFA were evaluated in this study. The mean number of surgical procedures performed before RFA was 1.2 (range 1-2) and the mean number of treated metastatic LNs per patient was 2 (rang 1-3). RFA was performed with an 18–gauge bipolar RF applicator under local anesthesia. Follow-up consisted of US and serum thyroglobulin (Tg) level at 1, 3, 6, 12 months and every 12 months thereafter.ResultsAll the patients were well tolerant to RFA procedure and no procedure-related complications occurred. During a mean follow-up time of 52.00 ± 21.44 months, the initial volume of LNs was 0.30 ± 0.38 ml, which significantly decreased to 0.01 ± 0.03 ml (P = 0.005) with a mean VRR of 99.28 ± 2.27%. A total of 9 metastatic LNs (90.00%) completely disappeared. After RFA, 2 patients developed newly metastases. One patient had additional RFA. The other one with multiple LN metastases underwent total thyroidectomy with central neck dissection.ConclusionAs a less invasive and effective technique, RFA may provide another alternative to the existing therapeutic modalities for cervical metastatic LNs in children and adolescents with PTC.
Highlights
Differentiated thyroid cancer (DTC) is the most common pediatric endocrine malignancy, accounting for 1% of all cancers in prepubertal children and up to 7% in adolescents, with a rising incidence in the pediatric population over the last decade [1]
For patients with small-volume cervical tumor, observation with thyroid-stimulating hormone (TSH) suppression could be considered, but there were no data to weigh the potential benefits against the potential risks of long-term suppression therapy for children and adolescents [2]. 131 I therapy was another option for small-volume cervical tumor
Between December 2014 to March 2018, 5 patients (3 females, 2 males, mean age 15.60 ± 2.97 years, range 12-19 years) with 10 metastatic lymph node (LN) from papillary thyroid carcinoma (PTC) were treated by Radiofrequency ablation (RFA) in our institution
Summary
Differentiated thyroid cancer (DTC) is the most common pediatric endocrine malignancy, accounting for 1% of all cancers in prepubertal children and up to 7% in adolescents, with a rising incidence in the pediatric population over the last decade [1]. The American Thyroid Association (ATA) guideline for children with thyroid nodules and DTC recommended three treatments for cervical metastatic LNs, which were repeat surgery, thyroid-stimulating hormone (TSH) suppression and 131 I therapy [2]. For patients with small-volume cervical tumor, observation with TSH suppression could be considered, but there were no data to weigh the potential benefits against the potential risks of long-term suppression therapy for children and adolescents [2]. 131 I therapy was another option for small-volume cervical tumor It could increase the risks of complications and secondary malignancies [6]. In children and adolescents, it may be reasonable or appropriate to consider less invasive alternatives than repeated surgery and 131 I therapy
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