Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation

Giovanni Mauri, Luca Cova, Tiziana Ierace, Alberto Baroli, Enzo Di Mauro, Claudio Maurizio Pacella, Shraga Nahum Goldberg, Luigi Solbiati

Research output: Contribution to journalArticle

Abstract

PURPOSE: To assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.

MATERIALS AND METHODS: 24 patients (62.3 ± 13.2 year; range 32-80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 (18)FDG-PET/CT-positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher's exact test and Mann-Whitney U test were used and Kaplan-Meier curve calculated.

RESULTS: Technical success was obtained in all 46 lymph nodes (100 %). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 %) patients. Overall, local control was obtained in 40/46 (86.9 %) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 %) patients. Local control was achieved in 40/46 (86.9 %) lymph nodes at 1 year and in all of the 25 nodes (100 %) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.

CONCLUSION: Ultrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.

Original languageEnglish
Pages (from-to)1023-30
Number of pages8
JournalCardioVascular and Interventional Radiology
Volume39
Issue number7
DOIs
Publication statusPublished - Jul 2016

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Laser Therapy
Neck
Lymph Nodes
Neoplasm Metastasis
Therapeutics
Quartz
Neck Dissection
Thyroglobulin
Thyroidectomy
Solid-State Lasers
Nonparametric Statistics
Papillary Thyroid cancer

Keywords

  • Journal Article

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Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation. / Mauri, Giovanni; Cova, Luca; Ierace, Tiziana; Baroli, Alberto; Di Mauro, Enzo; Pacella, Claudio Maurizio; Goldberg, Shraga Nahum; Solbiati, Luigi.

In: CardioVascular and Interventional Radiology, Vol. 39, No. 7, 07.2016, p. 1023-30.

Research output: Contribution to journalArticle

Mauri, Giovanni ; Cova, Luca ; Ierace, Tiziana ; Baroli, Alberto ; Di Mauro, Enzo ; Pacella, Claudio Maurizio ; Goldberg, Shraga Nahum ; Solbiati, Luigi. / Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation. In: CardioVascular and Interventional Radiology. 2016 ; Vol. 39, No. 7. pp. 1023-30.
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abstract = "PURPOSE: To assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.MATERIALS AND METHODS: 24 patients (62.3 ± 13.2 year; range 32-80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 (18)FDG-PET/CT-positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher's exact test and Mann-Whitney U test were used and Kaplan-Meier curve calculated.RESULTS: Technical success was obtained in all 46 lymph nodes (100 {\%}). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 {\%}) patients. Overall, local control was obtained in 40/46 (86.9 {\%}) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 {\%}) patients. Local control was achieved in 40/46 (86.9 {\%}) lymph nodes at 1 year and in all of the 25 nodes (100 {\%}) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.CONCLUSION: Ultrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.",
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T1 - Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation

AU - Mauri, Giovanni

AU - Cova, Luca

AU - Ierace, Tiziana

AU - Baroli, Alberto

AU - Di Mauro, Enzo

AU - Pacella, Claudio Maurizio

AU - Goldberg, Shraga Nahum

AU - Solbiati, Luigi

PY - 2016/7

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N2 - PURPOSE: To assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.MATERIALS AND METHODS: 24 patients (62.3 ± 13.2 year; range 32-80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 (18)FDG-PET/CT-positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher's exact test and Mann-Whitney U test were used and Kaplan-Meier curve calculated.RESULTS: Technical success was obtained in all 46 lymph nodes (100 %). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 %) patients. Overall, local control was obtained in 40/46 (86.9 %) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 %) patients. Local control was achieved in 40/46 (86.9 %) lymph nodes at 1 year and in all of the 25 nodes (100 %) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.CONCLUSION: Ultrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.

AB - PURPOSE: To assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.MATERIALS AND METHODS: 24 patients (62.3 ± 13.2 year; range 32-80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 (18)FDG-PET/CT-positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher's exact test and Mann-Whitney U test were used and Kaplan-Meier curve calculated.RESULTS: Technical success was obtained in all 46 lymph nodes (100 %). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 %) patients. Overall, local control was obtained in 40/46 (86.9 %) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 %) patients. Local control was achieved in 40/46 (86.9 %) lymph nodes at 1 year and in all of the 25 nodes (100 %) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.CONCLUSION: Ultrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.

KW - Journal Article

U2 - 10.1007/s00270-016-1313-6

DO - 10.1007/s00270-016-1313-6

M3 - Article

VL - 39

SP - 1023

EP - 1030

JO - CardioVascular and Interventional Radiology

JF - CardioVascular and Interventional Radiology

SN - 7415-5101

IS - 7

ER -