Single-center retrospective cohort study of neoadjuvant treatment for locally advanced thyroid cancer

Locally advanced thyroid cancer is associated with poor prognosis and high surgical morbitity. A retrospective study at Kaohsiung Chang Gung Memorial Hospital (Taiwan) evaluated feasibility and outcomes of neoadjuvant treatment including neoadjuvant therapy in 17 patients with locally advanced thyroid cancer. The patients received tyrosine kinase inhibitors (TKIs), transarterial embolization (TAE), and radiofrequency ablation (RFA), either alone or in combination. The primary outcome was the proportion of patients who proceeded to R0 or R1 surgical resection following neoadjuvant treatment. Four patients (23.5%) achieved R0 resection, and one additional patient (5.9%) achieved R1 resection. Most patients demonstrated reduced tumor burden and surgical complexity, as reflected by improvements in the MMM score and the Invasive Thyroid Class. The objective response rate was 47% and the 12-month progression-free survival rate was 58.2%. The authors conclude that neoadjuvant treatment may improve tumor downstaging and surgical feasibility in selected patients with initially unresectable thyroid cancer.