Microwave ablation for small papillary thyroid carcinomas: clinical outcomes and thyroid function preservation.

Abstract

Purpose: This study explores the impact of microwave ablation (MWA) on thyroid function in patients with small papillary thyroid carcinomas (SPTCs) using a specific energy/volume model to optimize treatment and evaluate clinical efficacy.

Methods: A cohort of 70 patients with confirmed SPTCs underwent MWA tailored to individual nodule characteristics. Pre- and post-ablation assessments included ultrasound imaging for nodule size and thyroid function tests (thyroid-stimulating hormone, free thyroxine and free triiodothyronine levels) were conducted at baseline, 1, 3, 6 and 12 months post-treatment. The main results are the complete ablation rate of nodules and the stability of thyroid function after treatment. Secondary outcomes include the incidence of complications and other clinical parameters.

Results: The complete ablation rate was achieved in 95% of the nodules, with most patients (90%) requiring a single ablation session. Nodule size reduced significantly from an average of 174.0 ± 259.1 to 3.2 ± 11.3 mm3, with a mean volume reduction rate of 98.47 (5.82%) at the 18-month follow-up. Stable thyroid function and minimal fluctuations in hormone levels were observed in 90% of patients, demonstrating the effectiveness of MWA in preserving thyroid function. Notably, lower energy/volume ratios were linked to a reduced risk of complications and preservation of thyroid function. Only 5% of patients reported minor complications, with no major adverse events.

Conclusions: The study's results validate the clinical utility of MWA in energy/volume setting as an effective, minimally invasive treatment for SPTCs.