Thermal ablation for papillary thyroid carcinoma in the isthmus: a systematic review and meta-analysis

Clinical investigations have demonstrated that the potential efficacy and safety of thermal ablation (TA) in treating papillary thyroid carcinoma in the isthmus (PTCI). However, almost all studies were non-randomized controlled trials with small sample sizes. This meta-analysis aims to comprehensively and systematically evaluate its effectiveness.

A systematic search for related studies was conducted in PubMed, EMBASE, and Cochrane Library from the database establishment to Jan 31, 2025. Outcomes including local tumor progression (LTP), postoperative volume, complete disappearance rate (CDR), locoregional recurrence (LRR), distant metastasis (DM) and complication, were evaluated for further analysis.

The meta-analysis included 560 unifocal PTCI from seven studies. No LTP was found in all patients. It was found that tumor volume had decreased significantly at 12 and 18 months following TA, in contrast to baseline measurements (P<0.05). The pooled analysis demonstrated an 88.10% CDR for PTCI [95% confidence interval (CI): 66.20-99.87%], with an overall complication incidence of 0.89% (95% CI: 0.13-2.08%). Six patients developed new tumors (0.77%; 95% CI: 0.04-2.06%). Lymph node metastasis (LNM) was documented in a single case (1/468; 95% CI: 0.00-0.56%). During the follow-up period, no patients were found to have DM.

This meta-analysis indicated that TA possesses promising efficacy and safety for individuals with PTCI. Multinational, prospective studies are warranted to confirm its generalizability in the future.