Radiofrequency ablation for papillary thyroid microcarcinoma with a trachea-adjacent versus trachea-distant location

Area of Science:

• Endocrinology
• Oncology
• Minimally Invasive Surgery

Background:

• Papillary thyroid microcarcinoma (PTMC) is a common thyroid malignancy.
• Radiofrequency ablation (RFA) is an emerging minimally invasive treatment for PTMC.
• The safety and efficacy of RFA for PTMC adjacent to the trachea require further evaluation.

Purpose of the Study:

• To assess the outcomes of RFA for PTMC located adjacent to the trachea.
• To compare these outcomes with RFA for PTMC distant from the trachea.
• To identify factors influencing disease progression after RFA.

Main Methods:

• Retrospective review of patients undergoing RFA for solitary low-risk PTMC (June 2014 - July 2020).
• Classification into 'adjacent' and 'distant' tracheal groups.
• Propensity score matching to balance confounders.
• Comparison of tumor volume, volume reduction ratio (VRR), tumor disappearance rates, complications, and disease progression.

Main Results:

• No significant differences were found between adjacent and distant groups in final tumor volume, VRR, tumor disappearance rates, disease progression, or complication incidence after propensity score matching.
• Overall VRR was 99.5% and cumulative tumor disappearance rate was 99.4% after a mean follow-up of 40.1 months.
• Tracheal adjacency was not associated with disease progression in multivariate analysis.

Conclusions:

• RFA is a safe and effective treatment option for PTMC, regardless of its proximity to the trachea.
• The location of PTMC relative to the trachea does not appear to impact RFA outcomes.
• RFA offers a viable alternative to traditional treatments for selected PTMC patients.