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Published on: September 15, 2023
Microwave ablation versus surgical resection for unifocal T1aN0M0 papillary thyroid carcinoma: a 10-year follow-up
Zi-Qi Wang1, Guo-Qing Sui1, Qi-Meihui Wang1
1Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China.
Objectives:
To evaluate the long-term oncological outcomes and safety of ultrasound-guided microwave ablation (MWA) compared to surgical resection (SR) for unifocal T1aN0M0 papillary thyroid carcinoma (PTC).
Materials And Methods:
This single-center retrospective analysis enrolled 134 patients with unifocal T1aN0M0 papillary thyroid carcinoma who underwent either ultrasound-guided MWA or SR between June and October 2014. Baseline demographic and clinical characteristics were well-balanced between the two cohorts. Primary endpoints included local tumor recurrence, new tumor, distant metastasis, and lymph node metastasis. Secondary endpoints comprised the volume reduction rate of the ablation zone and the incidence of procedure-related complications.
Results:
A total of 134 patients (mean age 43.53 ± 9.19 years, 99 females) were included in this study and followed for a complete period of 120 months. No statistically significant difference was observed in disease progression-free survival between the MWA and SR groups. The MWA group demonstrated a numerically lower overall complication rate compared to the SR group, with the majority of complications being transient. Permanent complications occurred only in the SR group.
Conclusion:
Long-term follow-up suggests that ultrasound-guided MWA could be considered a safe and effective therapeutic choice in addition to SR for selected patients with unifocal T1aN0M0 PTC.
Key Points:
Question What are the 10-year outcomes of ultrasound-guided MWA versus SR in patients with unifocal T1aN0M0 papillary thyroid carcinoma? Findings During long-term follow-up of patients treated with ultrasound-guided MWA, normal thyroid function was preserved without thyroid hormone replacement therapy. No permanent procedure-related complications were documented in the observation period. Clinical relevance These findings suggest that MWA could be considered as a treatment option in addition to SR for selected patients with unifocal T1aN0M0 PTC, potentially enabling a less invasive management approach. Further investigation is warranted to validate these preliminary results.
