International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2025
Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma.
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Cam Isa, Shatat Almotasem, Köksalan Damla, Atış Said, Yalnız Ahmet, Çakır Özgür, Selek Alev, Sözen Mehmet, Yaprak Bayrak Büşra, Öztürk Seda, Çakıllı Özge Telci, Cantürk Nuh Zafer, Çiftçi Ercüment
Аннотация
OBJECTIVE: Medullary thyroid carcinoma (MTC) is a rare, aggressive thyroid malignancy with frequent locoregional recurrence rate at 30-50%. Reoperative neck surgery is standard but challenging and risky. Ultrasound (US)-guided microwave ablation (MWA) offers minimally invasive alternatives, though evidence in recurrent MTC remains limited. This study evaluated the efficacy and safety of percutaneous US-guided MWA for treating recurrent MTC.
METHODS: A retrospective review included 22 patients with biopsy-proven locoregional recurrent MTC treated by US-guided percutaneous MWA after prior total thyroidectomy. All were either poor surgical candidates or declined reoperation. Thirty-four lesions underwent single-session outpatient ablation. Tumor size, serum calcitonin and volume reduction ratio (VRR) were assessed at baseline, 1, 3, 6 and 12 months post-ablation. Imaging and biochemical responses determined treatment outcomes. Recurrence-free survival between recurrent and non-recurrent groups was compared.
RESULTS: A total of 22 patients (median age 52 years; 14% hereditary) were included and MWA was successfully performed in all. Mean tumor diameter significantly reduced from 14.3 ± 11.6 mm to 2.6 ± 3.4 mm at 12 months (p < .001). Median serum calcitonin decreased significantly from 1165 pg/mL to 108 pg/mL at 12 months (p < .001). Treated lesions showed no regrowth; however, 50% developed new metastases elsewhere, correlating with higher initial metastatic burden (p = .001) and higher baseline calcitonin (p = .037).
CONCLUSION: US-guided MWA effectively reduces tumor volume and calcitonin levels in recurrent MTC with minimal morbidity, though close surveillance for new metastases remains essential.
METHODS: A retrospective review included 22 patients with biopsy-proven locoregional recurrent MTC treated by US-guided percutaneous MWA after prior total thyroidectomy. All were either poor surgical candidates or declined reoperation. Thirty-four lesions underwent single-session outpatient ablation. Tumor size, serum calcitonin and volume reduction ratio (VRR) were assessed at baseline, 1, 3, 6 and 12 months post-ablation. Imaging and biochemical responses determined treatment outcomes. Recurrence-free survival between recurrent and non-recurrent groups was compared.
RESULTS: A total of 22 patients (median age 52 years; 14% hereditary) were included and MWA was successfully performed in all. Mean tumor diameter significantly reduced from 14.3 ± 11.6 mm to 2.6 ± 3.4 mm at 12 months (p < .001). Median serum calcitonin decreased significantly from 1165 pg/mL to 108 pg/mL at 12 months (p < .001). Treated lesions showed no regrowth; however, 50% developed new metastases elsewhere, correlating with higher initial metastatic burden (p = .001) and higher baseline calcitonin (p = .037).
CONCLUSION: US-guided MWA effectively reduces tumor volume and calcitonin levels in recurrent MTC with minimal morbidity, though close surveillance for new metastases remains essential.