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Thermal Ablation for T1N0M0 Papillary Thyroid Carcinoma: A Long-term Multicenter Comparative Study with Subgroup
Han-Xiao Zhao1, Shu-Rong Wang2, Li-Hong Liu3
1China-Japan Friendship Institute of Clinical Medical Sciences, Beijing, China (H.X.Z.); Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (H.X.Z., Z.L.Z., L.L.P., Y.L., M.A.Y., Y.W.).
Academic Radiology
|October 4, 2025
Summary
Thermal ablation (TA) is effective for T1N0M0 papillary thyroid carcinoma (PTC). While multifocal PTC shows higher progression, retreatment with TA offers successful disease control.
Area of Science:
- Endocrinology
- Oncology
- Minimally Invasive Surgery
Background:
- Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy.
- Early-stage PTC (T1N0M0) management often involves surgery, but thermal ablation (TA) is an alternative.
- Long-term outcomes of TA for different T1N0M0 PTC subtypes require evaluation.
Purpose of the Study:
- To assess the long-term efficacy of TA for T1N0M0 PTC.
- To compare TA outcomes between unifocal T1a and T1b PTC.
- To compare TA outcomes between unifocal T1a and multifocal T1a PTC.
Main Methods:
- A multicenter retrospective study of 495 patients with T1N0M0 PTC.
- Follow-up duration averaged 79 months.
- Analysis included disease progression, disease-free survival, technical success, volume reduction, tumor disappearance, and complications.
Main Results:
- Disease progression rates were 4.3% for unifocal T1a, 8.2% for unifocal T1b, and 14.3% for multifocal T1a PTC.
- Multifocal T1a PTC showed significantly higher progression than unifocal T1a PTC (p=0.010).
- Multifocality was the sole independent risk factor for progression (HR: 5.601; p=0.001).
- Second TA achieved 96% success in controlling new tumors or lymph node metastasis (LNM).
- Technical success rate was 100%, median volume reduction rate was 100%, and complete tumor disappearance was 99.0% with a 2.8% complication rate.
Conclusions:
- TA is a safe and effective long-term treatment for T1N0M0 PTC.
- Multifocality is an independent risk factor for disease progression.
- Repeat TA is effective for managing new tumors or LNM, ensuring favorable outcomes.
