2022 The Indication For Thyroid Surgery Decreases Further Due to Novel Ablation Procedures For Benign and Thyroid Tumors

Thyroid 32(1) 2022 Tufano RP et al

“The year of technical advances in treating nodules and cancer”

Dr.Guttler’s comments on this special article on thyroid advances.

1. The number of surgeries for benign nodules has shown a dramatic drop since the 1970’s due to thyroid needle biopsies, thyroid ultrasound, molecular markers, ethanol ablation, and in 2018 the FDA approval of radiofrequency ablation for soft tissue use including thyroid nodules.

2. RFA has now become the treatment of choice of benign thyroid nodules. “RFA has faster recovery times, less pain, higher social and psychological well being compared to surgery.”

3. However the determination of a benign nodule has also improved.

4. Some are benign by ultrasound appearance alone.

5. Most are benign by cytology Class II.

6. Some are benign after molecular marker testing with no cancer markers and benign classifier.

7. Finally a suspicious classifier can be shown to be wrong when a PET/CT of the neck shows a low SUV activity of the nodule.

8. The actual patients with nodules with indication for surgery is continuing to be decreased with all the advances in diagnosis .

9. Also Dr Tufano also mentions the use of RFA for micropapallary thyroid cancer. He reports no difference in local tumor progression, lymph node metastasis, recurrence. The 4 year recurrence free survival rate was 98 % vs 97% for surgery.

10. Call me at 310-393-8860 or email to thyroid.manager@thyroid.com for details of my advanced diagnostic protocol to be sure you don’t need that thyroid surgery for a benign or suspicious nodule, and can be treated with thyroid RFA.

11. Selected small papillary thyroid cancer can be ablated with RFA in my office.

12. Select patents with a parathyroid adenoma in “safe” locations can be ablated without surgery by parathyroid RFA.

13. Ask for Alicia.

14. Dr.G