Efficacy and Safety of Thermal Ablation for Solitary Low-Risk T2N0M0 Papillary Thyroid Carcinoma.

IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Korean Journal of Radiology Pub Date : 2024-08-01 DOI:10.3348/kjr.2023.1279
Yu-Lin Fei, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Shi-Liang Cao, Jie Wu, Hui-Di Zhou, Ming-An Yu
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Abstract

Objective: To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA).

Materials and methods: This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates.

Results: The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355).

Conclusion: Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.

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热消融治疗单发低风险 T2N0M0 甲状腺乳头状癌的有效性和安全性
目的评估热消融治疗单发低危T2N0M0甲状腺乳头状癌(PTC)的疗效和安全性,并比较微波消融(MWA)和射频消融(RFA)的疗效:这项回顾性单中心研究涉及34名患者(年龄:40.0±13.9岁;28名女性),他们都患有最大直径大于2厘米且小于4厘米的低风险T2N0M0 PTC,并在2016年11月至2023年4月期间接受了微波消融(MWA)(n = 15)或射频消融(RFA)(n = 19)。主要结果是疾病进展累积率和延迟手术率。而次要结果包括肿瘤大小变化、肿瘤完全消失累积率和并发症发生率:中位随访时间为 18.0 个月(四分位数间距 [IQR]:9.0-40.0 个月)。12 个月时,消融区体积缩小率的中位数为 74.2%(IQR:53.7%-86.0%)。有两名患者在 1 年内出现疾病进展,其中一名患者在 RFA 术后出现局部肿瘤进展,另一名患者在 MWA 术后出现新的肿瘤,因此在剩余的随访期内,累计疾病进展率为 8.8%(95% 置信区间 [CI]:0%-19.8%)。两名患者随后都接受了额外的消融治疗,无需手术。1年、3年和5年的肿瘤完全消失累积率分别为4.0%(95% CI:0%-11.4%)、26.8%(95% CI:2.7%-44.9%)和51.2%(95% CI:0%-79.1%)。MWA组和RFA组的疾病进展率(P = 0.829)和肿瘤完全消失率(P = 0.633)无明显差异。在出现一过性声音嘶哑的患者中,14.7%(5/34)出现了并发症。RFA 的并发症发生率高于 MWA(21.1% [4/19] vs. 6.7% [1/15];P = 0.355),但无统计学意义:结论:在治疗单发低风险 T2N0M0 PTC 时,MWA 和 RFA 在疗效和安全性方面均表现出良好的短期疗效,且无显著差异。
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来源期刊
Korean Journal of Radiology
Korean Journal of Radiology 医学-核医学
CiteScore
10.60
自引率
12.50%
发文量
141
审稿时长
1.3 months
期刊介绍: The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.
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