About this Research Topic
Ultrasound (US)-guided radiofrequency ablation (RFA) for thyroid lesions is a minimally invasive treatment modality that may be an alternative to surgery in patients with benign thyroid nodules. In addition, it may have an effective complementary role in the management of recurrent thyroid cancers. Recently, RFA has been attempted for patients with papillary thyroid microcarcinoma (PTMC).
The impact of radiofrequency ablation (RFA) on health-related quality of life (HRQL) in patients with benign thyroid nodules (TN) has been demonstrated by recent studies by different groups. RFA of benign TNs is effective in reducing nodular volume and compressive and cosmetic symptoms, without causing thyroid dysfunction or life-threatening complications. In fact, the RFA is a percutaneous treatment that results in thermal tissue necrosis and fibrosis. As a result of this process, the nodules shrink. Clinical trials in Italy and South Korea demonstrated a 50 to 80 percent durable nodule shrinkage after thyroid nodule RFA.
Moreover, RFA can be indicated for autonomously functioning thyroid nodule in cases with compression of adjacent structures, hyperthyroid symptoms, and in pre-toxic nodules avoiding therapies that could complicate pre-existing chronic disorders in the elderly or that are controversial in young women, like radioactive iodine therapy.
Indications for RFA for primary thyroid cancers have not yet been clearly established. However, in patients with primary thyroid cancer, in particular PMTC, who refuse surgery or with comorbidities making surgery potentially risky, RFA can be considered as an alternative. Radiofrequency ablation can be performed for curative or palliative purposes in the recurrent thyroid cancers for those patients at high surgical risk or who refuse surgery.
Additionally, there are several reports concerning the palliative treatment of anaplastic or advanced medullary thyroid cancer using RFA. RFA can reduce symptoms and improve the quality of life of the patient even if complete radiological removal is not amenable.
The goal of this Research Topic for Frontiers in Endocrinology is to highlight the current and future role that RFA may have as an alternative therapeutic approach to benign and malignant thyroid pathologies (especially as an alternative to the active surveillance programs), and to enhance considerations for the use of minimally invasive strategies in selected populations such as the elderly or frail patients. We encourage authors to submit manuscripts in the form of Original Research, Review, Mini-Review, Methods, Perspective, Hypothesis & Theory, and Opinion articles.
Keywords: radiofrequency ablation (RFA), ultrasound, directed therapy, fine needle biopsy, thyroid nodules
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