Thermal Ablation for Small Papillary Thyroid Cancer: A Potential Game Changer
Menée auprès de 847 patients atteints d'un carcinome papillaire de la thyroïde de stade T1N0M0 et non éligibles à la chirurgie (âge moyen : 46 ans ; 660 femmes ; durée moyenne de suivi : 22 mois), cette étude multicentrique évalue l'efficacité, du point de vue du taux de progression de la maladie, et la sécurité d'un traitement par thermo-ablation (micro-ondes ou radiofréquence)
The increase in the incidental detection of small low-risk papillary thyroid carcinoma (PTC) has sparked active discussion about treatment options and made it imperative to consider nonsurgical treatment, such as active surveillance (AS) and thermal ablations. This was reflected in the 2015 guidelines by the American Thyroid Association, which endorsed AS as an alternative to immediate surgery for low-risk PTC measuring up to 1 cm (papillary thyroid microcarcinoma, T1a). In a recent meta-analysis, pooled 5-year follow-up data for AS showed an acceptable tumor progression rate (5.3% with size enlargement, 1.6% with lymph node metastasis) among patients undergoing AS. There are ongoing clinical trials to extend the size threshold for AS to 2 cm (T1b).
Radiology , éditorial, 2020