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RISS 인기검색어
- 검색키워드
- 저자 : Vicente Pereg (검색결과 2 건)
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Santiago Tofé,Iñaki Argüelles,Guillermo Serra,Honorato García,Antonia Barcelo,Vicente Pereg 대한갑상선학회 2020 International Journal of Thyroidology Vol.13 No.2
Background and Objectives: Neck recurrences of thyroid cancer are frequently detected in routine ultrasound (US)follow-up. Broad management of these lesions may include active surveillance, surgery or local percutaneoustechniques, but for the latter, little is known about impact on long-term follow-up and need of subsequentradioactive iodine (RAI) therapy. Materials and Methods: 42 patients underwent US-guided ethanol ablation (EA)over 71 thyroid bed or lymph node confirmed recurrences. All volume reduction >50%, absence of power Dopplersignal and fine needle aspiration (FNA) washout thyroglobulin (Tg) value <1 ng/mL should be present to considera complete ablation. Patients with TNM stage I-II, ≤2 lesions and/or baseline plasma TSH-suppressed Tg level <0.2ng/mL did not undergo post-EA RAI therapy. Post-EA plasma Tg values were compared to baseline in patientswith and without subsequent RAI therapy. Results: 62 lesions (87.32%) achieved a complete ablation after a meanfollow-up of 40.5 months (range, 12-73). Four treated lesions (5.63%) recurred (3/39 and 1/32 in patients withand without subsequent RAI therapy), and 7 patients (16.66%) developed new recurrences throughout follow-up(5/19 and 2/23 with and without RAI therapy). Both plasma TSH-suppressed and TSH-stimulated Tg levelsdescended after EA in both groups, and 17/38 (44.73%) patients achieved a TSH-suppressed Tg <0.2 ng/mL,with no differences between both groups of patients. All EA procedures were conducted safely without seriousor persistent side effects. Conclusion: Successful EA were achieved safely in 87.32% of patients with recurrentthyroid cancer, with a positive effect on systemic disease as reflected by plasma post-EA Tg levels. A subset ofpatients with TNM stage III, ≤2 lesions and/or low pre-EA plasma Tg levels may not need subsequent RAI therapyafter successful ablation. Overall, EA is an effective and balanced therapy for selected patients with neck recurrentthyroid cancer as an alternative to surgery.
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Santiago Tofé,Iñaki Argüelles,Cristina Álvarez,Álvaro Tofé,Alessandra Repetto,Antonia Barceló,Vicente Pereg 대한이비인후과학회 2023 Clinical and Experimental Otorhinolaryngology Vol.16 No.4
Objectives. Neck recurrence of papillary thyroid cancer (PTC) is frequently detected after initial surgery. The managementof these lesions may include rescue surgery (RS) or minimally invasive techniques in selected patients, but compara-tive studies evaluating the effectiveness and safety of these techniques are lacking. In this paper, we compared ultra-sound-guided ethanol ablation (EA) in selected patients to RS in a matched cohort. Methods. We retrospectively compared 41 patients and 41 matched PTC patients without known distant metastases, whounderwent ultrasound-guided EA or RS (matched reference group), who had 63 and 75 thyroid bed and/or lymphnode confirmed PTC recurrences during a median follow-up of 72.8 and 89.6 months, respectively. The primary out-come was time until structural recurrence, compared using Kaplan-Meier survival curves. The secondary outcomesincluded time until biochemical recurrence, plasma thyroglobulin (Tg) levels, American Thyroid Association (ATA) re-sponse-to-therapy categories by the last available observation, and treatment-derived complications in each group. Results. No significant differences were found between the EA and RS groups for time until structural recurrence (log-ranktest, P =0.94). The time until biochemical recurrence was also similar (P =0.51); and the plasma Tg concentration re-duction and proportions of patients in the ATA reclassification categories were also similar. A significantly higher pro-portion of patients in the RS group presented treatment-derived complications (29.27% vs. 9.75%, P <0.05). Conclusion. In this retrospective analysis, the treatment of PTC neck recurrence with EA in selected patients was compara-ble to RS in a matched reference group for the long-term risk of structural or biochemical relapse, but with a lowerrisk of treatment-derived complications. These results support the effectiveness and safety of this minimally invasivetechnique in the management of selected patients with recurrent PTC.
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