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Efficacy of Percutaneous Thermal Ablation of Papillary Thyroid Carcinoma
Ettore Caruso,Ettore Gagliano,Gianlorenzo Dionigi 대한갑상선-내분비외과학회 2019 The Koreran journal of Endocrine Surgery Vol.19 No.4
Percutaneous thermoablation (PTA) has become an increasingly used option in the interventional treatment of symptomatic, cytologic and sonographic benign solid thyroid gland disease. Currently, there is no high-level evidence of treatment for differentiated thyroid cancer by means of PTA. Surgery is a standard treatment for primary and also for recurrent thyroid cancer, followed by radioactive iodine and thyroid hormone therapy. PTA, however, can be used in patients at high-risk and in patients who refuse to undergo repeated surgery. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the optimal use of PTA for thyroid nodules. However, there are still several questions on safe distance to the laryngeal nerves, no data on duration of PTA application around the nerves, no intra-procedure assessment of laryngeal nerves function and position. Future experimental studies are required.
Alessandro Pontin,Ettore Gagliano,Gianlorenzo Dionigi 대한갑상선-내분비외과학회 2019 The Koreran journal of Endocrine Surgery Vol.19 No.4
Papillary thyroid carcinoma (PTC) is a heterogeneous tumor group with differing pathogenesis and prognosis of the individual subtypes. In addition, a tumor entity has been spun off, now referred to as “noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP). A recent study, based on a comprehensive evaluation of a prospective multicenter NIFTP-based retrospective study, was intended to clarify whether NIFTP can metastasize and thus justify a reduced resection rate compared to classical PTC. For 3 reasons, Authors nicely recommend caution regarding a limited thyroid procedure (i.e. lobectomy vs. completion thyroidectomy): i) In the current literature, lymph node metastases have been described in 10 patients with NIFTP, and in 1 patient lung metastases. ii) As reported for the first time in this study, nearly one-fifth of patients have NIFTP-associated PTMC with unclear potential for metastasis. iii) Observation periods are still relatively short and so far, there are no agreed follow-up standards.