4.5 Review

Thermal Ablation for the Management of Papillary Thyroid Microcarcinoma in the Era of Active Surveillance and Hemithyroidectomy

Journal

CURRENT ONCOLOGY REPORTS
Volume 24, Issue 8, Pages 1045-1052

Publisher

SPRINGER
DOI: 10.1007/s11912-022-01268-2

Keywords

Papillary thyroid microcarcinoma; Active surveillance; Surgery; Thermal ablation

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Thermal ablation can be a good alternative treatment option for patients with low-risk papillary thyroid microcarcinomas (PTMC). It has comparable oncologic outcomes to immediate surgery with fewer complications. Active surveillance may lead to a substantial proportion of patients opting for surgery.
Purpose of Review Thermal ablation presents a therapeutic option other than active surveillance and immediate surgery for patients with low-risk papillary thyroid microcarcinomas (PTMC). Here, we have reviewed the current oncologic outcome of thermal ablation in PTMC cases and compared it with active surveillance and surgery. Recent Findings Thermal ablation in PTMC cases revealed no tumor progression for pooled 5-year follow-up data. This oncologic outcome of thermal ablation was comparable to that of immediate surgery with less morbidity. Additionally, no patient who underwent thermal ablation received delayed surgery during the follow-up period due to anxiety. However, active surveillance has indicated that a substantial proportion (range, 8-32%) of patients underwent surgery mainly due to anxiety. Summary In a subset of PTMC patients who are high-risk surgical candidates or who refuse surgery, especially those who have failed or are reluctant to pursue active surveillance, thermal ablation can be a good option.

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