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Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study |
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| Authors: | Yangsean Choi Ja-Sung Bae So-Hee Lee Chan-Kwon Jung Jinhee Jang |
| Institution: | 1. Department of Radiology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea;2. Department of Thyroid Surgery, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea;3. Department of Pathology, The Catholic University of Korea College of Medicine, Seoul St. Mary’s Hospital, Seoul, Korea |
| Abstract: | Purpose: To compare the efficacy and complication rates of radiofrequency ablation (RFA) and repeat surgery in the treatment of locally recurrent thyroid cancers. Materials and methods: A total of 221 patients with locally recurrent thyroid cancers who underwent either RFA (n?=?96) or repeat surgery (n?=?125) between March 2008 and March 2017 were retrospectively enrolled (range of follow-up, 1–10?years). Each cohort consisted of 70 patients after propensity score adjustment. Patients with more than three recurrent lesions were excluded. The primary and secondary end points were recurrence-free survival and complication rates, respectively. Recurrence-free survival curves were compared via the log-rank test. The complications—voice changes, hypocalcemia, and immediate procedural complications—were compared between the groups. In addition, pretreatment serum thyroglobulin (Tg) levels and those at the last follow-up were also compared between the two groups to examine therapeutic efficacy. Results: After propensity score matching, both groups showed no significant differences in baseline characteristics. The recurrence-free survival rates were comparable between the RFA and surgery groups (p?=?.2). There were no significant differences in mean serum Tg levels and their mean decrease after treatment between the groups (p?=?.891 and p?=?.963, respectively). Immediate procedural complications and voice changes also showed no significant between-group differences (p?=?.316, p?=?.084, respectively). Hypocalcemia occurred only in the repeat surgery group (n?=?18). Overall complications were significantly more frequent in the repeat surgery group (RFA, n?=?7; surgery, n?=?27; p?<?.001). Conclusion: RFA may be an effective and safe alternative to repeat surgery in the treatment of a small number of locally recurrent thyroid cancers. |
| Keywords: | Thyroid radiofrequency ablation recurrent thyroid cancer ultrasound thermal ablation |