The Efficacy And Follow-up Study Of Percutaneous Ultrasound-guided Microwave Thermal Ablation For Papillary Thyroid Carcinoma

Part 1 Clinical follow-up assessment of ultrasound-guided microwavethermal ablation treatment in cN0 papillary thyroid carcinomaObjective To investigate the clinical effect of ultrasound-guided microwave thermal ablation in cN0 thyroid papillary carcinoma.Methods From October 2011 to May 2017,totally 222 patients with cN0 thyroid papillary carcinoma were collected and followed up who underwent microwave ablation at Shanghai Changzheng Hospital or Shanghai International Medical Center.We analyzed that including the incidence of the disease and the recurrence rate.Results There were no serious complications after microwave ablation.One case of neck lymph node metastasis and one case of new tumor were found in other parts of the thyroid gland after follow-up.We performed secondary ablation,and no recurrence occurred after follow-up.The original lesion were reduced to varying degrees,whose average reduction rate about 87.34%.Total of 56 cases of complete absorption of the lesion.Conclusion The clinical effect is good about microwave thermal ablation in cN0 papillary thyroid carcinoma.Microwave thermal ablation may be an important means in the future about treatment of papillary thyroid carcinoma.Part 2 The clinical efficacy and risk factors of recurrence about cN1 papillary thyroid carcinoma with microwave thermal ablation Objective This study aims to investigate the clinical efficacy and risk factors of recurrence about microwave thermal ablation in cN1 thyroid papillary carcinoma.Methods From July 2013 to April 2017,55 patients with cN1 thyroid papillary carcinoma who were performed microwave ablation at Shanghai Changzheng Hospital or Shanghai International Medical Center.There were 32 cases in cN1 a stage and 18 cases in cN1 b stage.We investigate the clinical efficacy of microwave ablation in cN1 thyroid papillary carcinoma and the relationship with recurrence,such as gender,age,primarytumor size,multiple tumor focus.One-way differences affecting recurrence were compared using log rank test and multivariate analysis using COX regression model.Results There were 9 cases of neck lymph node metastasis and 3 cases of new tumor in other parts of the gland.No cases of distant metastasis were observed.The overall recurrence rate was 24%.Log rank test analysis showed that sex,number of tumor lesions and lateral cervical lymph node metastasis were the recurrence factors after microwave ablation.Multivariate analysis showed that number of tumor lesions and lateral cervical lymph node metastasis were the recurrence factors after microwave ablation.Conclusion Microwave treatment of cN1 papillary thyroid carcinoma has a good clinical effect with good reproducibility.A high recurrence rate after only once ablation.But repeat ablation does not increase the incidence of complications.