PDF(Pubmed)
Abstract：
OBJECTIVE: To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA).
METHODS: This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates.
RESULTS: The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355).
CONCLUSIONS: Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.
METHODS: This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates.
RESULTS: The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355).
CONCLUSIONS: Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.
摘要：
目的：评价热消融治疗单发低危T2N0M0甲状腺乳头状癌（PTC）的疗效和安全性，并比较微波消融（MWA）和射频消融（RFA）的疗效。
方法：本回顾性研究，单中心研究纳入了34例患者(年龄:40.0±13.9岁;28例女性),这些患者在2016年11月至2023年4月期间患有低危T2N0M0PTC,最大直径>2cm且≤4cm,并接受了MWA(n=15)或RFA(n=19).主要结果是疾病进展的累积率和延迟手术率。相比之下,次要结果包括肿瘤大小的变化，肿瘤完全消失的累积率，和并发症发生率。
结果：中位随访期为18.0个月（四分位距[IQR]：9.0-40.0个月）。12个月时,消融区容积减少率中位数为74.2%(IQR:53.7%-86.0%).在1年内有两名患者出现疾病进展，包括一名RFA后局部肿瘤进展的患者和一名MWA后新肿瘤的患者，导致整个剩余随访期间的累积疾病进展率为8.8%(95%置信区间[CI]:0%-19.8%).两名患者随后接受了额外的消融治疗，不需要手术。1年、3年和5年肿瘤完全消失的累积率为4.0%(95%CI:0%-11.4%),26.8%（95%CI：2.7%-44.9%），和51.2%（95%CI：0%-79.1%），分别。MWA和RFA组之间的疾病进展率（P=0.829）或肿瘤完全消失率（P=0.633）没有显着差异。出现短暂性声音嘶哑的患者占14.7％（5/34）。RFA的并发症发生率高于MWA，但无统计学意义(21.1%[4/19]vs.6.7%[1/15]；P=0.355）。
结论：MWA和RFA在治疗单发低危T2N0M0PTC的疗效和安全性方面均显示出有希望的短期结果，没有显著差异。
方法：本回顾性研究，单中心研究纳入了34例患者(年龄:40.0±13.9岁;28例女性),这些患者在2016年11月至2023年4月期间患有低危T2N0M0PTC,最大直径>2cm且≤4cm,并接受了MWA(n=15)或RFA(n=19).主要结果是疾病进展的累积率和延迟手术率。相比之下,次要结果包括肿瘤大小的变化，肿瘤完全消失的累积率，和并发症发生率。
结果：中位随访期为18.0个月（四分位距[IQR]：9.0-40.0个月）。12个月时,消融区容积减少率中位数为74.2%(IQR:53.7%-86.0%).在1年内有两名患者出现疾病进展，包括一名RFA后局部肿瘤进展的患者和一名MWA后新肿瘤的患者，导致整个剩余随访期间的累积疾病进展率为8.8%(95%置信区间[CI]:0%-19.8%).两名患者随后接受了额外的消融治疗，不需要手术。1年、3年和5年肿瘤完全消失的累积率为4.0%(95%CI:0%-11.4%),26.8%（95%CI：2.7%-44.9%），和51.2%（95%CI：0%-79.1%），分别。MWA和RFA组之间的疾病进展率（P=0.829）或肿瘤完全消失率（P=0.633）没有显着差异。出现短暂性声音嘶哑的患者占14.7％（5/34）。RFA的并发症发生率高于MWA，但无统计学意义(21.1%[4/19]vs.6.7%[1/15]；P=0.355）。
结论：MWA和RFA在治疗单发低危T2N0M0PTC的疗效和安全性方面均显示出有希望的短期结果，没有显著差异。
