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Published on: September 15, 2023
Thermal Ablation Versus Thyroid Lobectomy for Subcapsular Papillary Thyroid Microcarcinoma: A Multicenter
Haoyu Jing1, Ruifang Xu2, Lin Yan3
1Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China; Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
Thermal ablation (TA) and thyroid lobectomy (TL) show similar efficacy for treating subcapsular papillary thyroid microcarcinoma (PTMC). TA offers a comparable alternative with fewer complications, especially for patients ineligible for or refusing lobectomy.
Area of Science:
- Endocrinology
- Surgical Oncology
- Minimally Invasive Procedures
Background:
- Papillary thyroid microcarcinoma (PTMC) is a common thyroid malignancy.
- Subcapsular PTMC presents unique management considerations.
- Current treatment options include thermal ablation (TA) and thyroid lobectomy (TL).
Purpose of the Study:
- To compare the efficacy of TA versus TL for clinical node-negative (cN0) subcapsular PTMC.
- To evaluate the impact of occult lymph node metastasis (LNM) and pathologic local invasion on outcomes.
- To assess complication rates associated with each treatment modality.
Main Methods:
- Retrospective study at three referral centers involving 536 patients treated with TA and 740 with TL.
- Patients had unifocal cN0 subcapsular PTMC.
- Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used for analysis.
Main Results:
- After PSM, no significant differences in disease progression or 5-year progression-free survival (PFS) rates between TA and TL groups.
- TA showed comparable PFS rates to occult LNM-positive and pathologic local invasion-positive subgroups.
- TA had significantly lower complication rates (0.4% vs. 2.1%) compared to TL.
Conclusions:
- TA and TL demonstrate comparable 5-year disease progression and PFS rates for eligible subcapsular PTMC patients.
- TA is a viable alternative treatment option for subcapsular PTMC.
- TA offers a potentially safer approach with fewer complications than TL.
