Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 31;13(10):1752-1758.
doi: 10.21037/gs-24-285. Epub 2024 Oct 26.

Treatment outcomes in patients with papillary thyroid cancer undergoing radiofrequency ablation of metastatic lymph nodes

Alexandra LaForteza  1 , Emily Persons  2 , Mohammad Hussein  1   3 , Xinyi Luo  1 , Peter P Issa  2 , Jessan Jishu  2 , Mohamed Shama  1 , Eman Toraih  1   4 , Emad Kandil  1
Affiliations

Treatment outcomes in patients with papillary thyroid cancer undergoing radiofrequency ablation of metastatic lymph nodes

Alexandra LaForteza et al. Gland Surg. .

Abstract

Background: Lymph node metastases in papillary thyroid cancer (PTC) increases recurrence risk and negatively impact survival. Traditional treatments like re-operation and radioactive iodine (RAI) have downsides. Radiofrequency ablation (RFA) is an emerging non-surgical therapeutic option, but there is seldom data on its efficacy and safety specifically for metastatic lymph nodes. We aimed to evaluate clinical outcomes of RFA applied to cervical lymph nodes in patients with PTC metastasis in North American population.

Methods: This was a single-institution retrospective analysis of 68 PTC patients with lymph nodes who underwent percutaneous RFA from January 2020 to December 2022. Volume reduction ratio (VRR), changes in thyroglobulin (Tg) levels, lymph node regrowth rate, and complications were assessed. Treatment response and outcomes were analyzed.

Results: Median lymph node maximum diameter was 12.9 mm and median volume was 0.27 mL at baseline. After RFA, median VRR was 79.5% [interquartile range (IQR), 50-89.7%]. Post-RFA, Tg to an average of 0.2 ng/mL (IQR, 0-0.6 ng/mL). In the 19 patients (27.9%) with undetectable Tg after RFA, median VRR was 86% (IQR, 73-94%). Quantitative Tg decrease strongly correlated with VRR percentage (r=0.82, P<0.001). Lymph node regrowth was seen in 5 patients (7.4%) over median 18 months follow-up. Only one patient experienced transient thermal injury associated with Horner's syndrome and symptoms resolved within 1 month.

Conclusions: In patients with PTC and metastatic cervical lymph nodes, RFA provided marked volume reduction and meaningful biochemical response without major complications. Excellent radiographic control was achieved in most patients. RFA demonstrates early promise as an emerging non-surgical therapeutic option for PTC patients with metastatic lymph nodes.

Keywords: Radiofrequency ablation (RFA); lymph node; thyroglobulin; thyroid cancer.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-24-285/coif). E.K. serves as an Editor-in-Chief of Gland Surgery from May 2024 to April 2026. E.K. receives consulting fees from TaeWoong (STARmed). The other authors have no conflicts of interest to declare.

Similar articles

See all similar articles

Cited by

References

    1. Coca-Pelaz A, Rodrigo JP, Shah JP, et al. Recurrent Differentiated Thyroid Cancer: The Current Treatment Options. Cancers (Basel) 2023;15:2692. 10.3390/cancers15102692 - DOI - PMC - PubMed
    1. Gimm O, Dralle H. Differentiated thyroid carcinoma. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001. - PubMed
    1. Mansour J, Sagiv D, Alon E, et al. Prognostic value of lymph node ratio in metastatic papillary thyroid carcinoma. J Laryngol Otol 2018;132:8-13. 10.1017/S0022215117002250 - DOI - PubMed
    1. Yan B, Hou Y, Chen D, et al. Risk factors for contralateral central lymph node metastasis in unilateral cN0 papillary thyroid carcinoma: A meta-analysis. Int J Surg 2018;59:90-8. 10.1016/j.ijsu.2018.09.004 - DOI - PubMed
    1. Sapuppo G, Tavarelli M, Russo M, et al. Lymph node location is a risk factor for papillary thyroid cancer-related death. J Endocrinol Invest 2018;41:1349-53. 10.1007/s40618-018-0865-5 - DOI - PubMed

LinkOut - more resources