Radiofrequency ablation of papillary thyroid microcarcinoma

Papillary thyroid microcarcinoma (PTMC), defined as papillary thyroid carcinoma measuring ≤1 cm, has emerged as a distinct clinical entity with a generally indolent course. The optimal management of PTMC remains controversial, with three main strategies currently adopted: surgical resection, active surveillance, and image-guided thermal ablation ( 16). This review provides a comprehensive analysis of these approaches, emphasizing their indications, outcomes, and limitations. Conventional surgery remains the gold standard, ensuring complete tumor excision but often associated with overtreatment, postoperative complications, and quality-of-life impairment. Active surveillance has gained acceptance as a conservative option for low-risk PTMC, reducing unnecessary interventions yet requiring long-term follow-up and patient compliance. Among minimally invasive alternatives, radiofrequency ablation (RFA) has shown growing evidence as a safe and effective technique for selected patients, achieving local tumor control with minimal morbidity and favorable cosmetic results. The review critically compares the efficacy, safety profiles, and patient selection criteria across these management modalities, highlighting the role of RFA as an emerging therapeutic tool that bridges the gap between surgical and observational strategies in the individualized treatment of PTMC.