Arun Upadhyaya, Sadhana Acharya Upadhyaya, Luchen Chang, Li Yuanyuan, Wei Xi
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Similarly, pooled estimates of changes in the largest diameter, volume, and serum thyroglobulin (Tg) were evaluated post-ablation. Subgroup analysis by treatment modality was performed. Study heterogeneity was analyzed using Q statistics and inconsistency index (I<sup>2</sup>). The quality of the studies was assessed using the MINORS scale.</p><p><strong>Results: </strong>Eleven studies with 233 patients and 432 CLNM were analyzed. The pooled VRR was 95.24% [95% Confidence Interval (CI): 91.97- 98.51%], complete disappearance was 63.1%, and recurrence was 1.6%. Changes in largest diameter, volume, and serum Tg were 8.36 mm (95%CI: 6.46-10.26mm), 216.09mm³, and 6.12ng/ml, respectively. Major complications occurred at 3.0%, while minor complications were 25.6%. Significant heterogeneity was found for diameter, volume, VRR, Tg, and minor complications. Subgroup analysis showed that MWA had a higher VRR (97.18%) than RFA (93.84%) (P < 0.001).</p><p><strong>Conclusion: </strong>Both RFA and MWA were effective and safe for treating CLNM from PTC. However, RFA showed lower volume reduction than MWA with significant heterogeneity in VRR.</p><p><strong>Data availability statement: </strong>The original contributions revealed in the study are included in the article/Supplemental Material. 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Among 544 papers, 11 articles were reviewed involving 233 patients and 432 CLNM cases. Random- or fixed-effects models assessed pooled proportions of volume reduction rate (VRR), complete disappearance, recurrence, major and minor or other complications. Similarly, pooled estimates of changes in the largest diameter, volume, and serum thyroglobulin (Tg) were evaluated post-ablation. Subgroup analysis by treatment modality was performed. Study heterogeneity was analyzed using Q statistics and inconsistency index (I<sup>2</sup>). The quality of the studies was assessed using the MINORS scale.</p><p><strong>Results: </strong>Eleven studies with 233 patients and 432 CLNM were analyzed. The pooled VRR was 95.24% [95% Confidence Interval (CI): 91.97- 98.51%], complete disappearance was 63.1%, and recurrence was 1.6%. Changes in largest diameter, volume, and serum Tg were 8.36 mm (95%CI: 6.46-10.26mm), 216.09mm³, and 6.12ng/ml, respectively. Major complications occurred at 3.0%, while minor complications were 25.6%. Significant heterogeneity was found for diameter, volume, VRR, Tg, and minor complications. Subgroup analysis showed that MWA had a higher VRR (97.18%) than RFA (93.84%) (P < 0.001).</p><p><strong>Conclusion: </strong>Both RFA and MWA were effective and safe for treating CLNM from PTC. However, RFA showed lower volume reduction than MWA with significant heterogeneity in VRR.</p><p><strong>Data availability statement: </strong>The original contributions revealed in the study are included in the article/Supplemental Material. 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引用次数: 0
摘要
目的：评价射频消融（RFA）和微波消融（MWA）治疗甲状腺乳头状癌（PTC）颈部淋巴结转移（CLNM）的疗效和安全性。方法：检索Medline、EMBASE、Web of Science和Cochrane Library，检索截至2024年7月热消融治疗PTC CLNM的有效性和安全性研究。在544篇文献中，回顾了11篇文献，涉及233例患者和432例CLNM病例。随机或固定效应模型评估了体积缩小率（VRR）、完全消失、复发、主要和次要并发症或其他并发症的总比例。同样，对消融后最大直径、体积和血清甲状腺球蛋白（Tg）的变化进行综合评估。按治疗方式进行亚组分析。采用Q统计量和不一致指数（I2）分析研究异质性。使用未成年人量表评估研究的质量。结果：11项研究，233例患者和432例CLNM进行了分析。合并VRR为95.24%[95%可信区间（CI）： 91.97 ~ 98.51%]，完全消失为63.1%，复发率为1.6%。最大直径、体积和血清Tg的变化分别为8.36 mm （95%CI: 6.46 ~ 10.26mm）、216.09mm³和6.12ng/ml。主要并发症占3.0%，次要并发症占25.6%。直径、体积、VRR、Tg和轻微并发症均存在显著异质性。亚组分析显示MWA的VRR（97.18%）高于RFA (93.84%) （P < 0.001）。结论：RFA和MWA治疗PTC源性CLNM均安全有效。然而，RFA在VRR中的体积缩小率低于MWA，且具有显著的异质性。数据可用性声明：研究中揭示的原始贡献包含在文章/补充材料中。进一步的询问可向通讯作者提出。
Ultrasound‑guided Percutaneous Radiofrequency and Microwave Ablation for Cervical Lymph Node Metastasis from Papillary Thyroid Carcinoma: A Systematic Review and Meta‑analysis of Clinical Efficacy and Safety.
Aim: To evaluate the efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for treating cervical lymph node metastasis (CLNM) from papillary thyroid carcinoma (PTC).
Methods: Medline, EMBASE, Web of Science, and Cochrane Library were searched for studies on the efficacy and safety of thermal ablations for treating CLNM from PTC until July 2024. Among 544 papers, 11 articles were reviewed involving 233 patients and 432 CLNM cases. Random- or fixed-effects models assessed pooled proportions of volume reduction rate (VRR), complete disappearance, recurrence, major and minor or other complications. Similarly, pooled estimates of changes in the largest diameter, volume, and serum thyroglobulin (Tg) were evaluated post-ablation. Subgroup analysis by treatment modality was performed. Study heterogeneity was analyzed using Q statistics and inconsistency index (I2). The quality of the studies was assessed using the MINORS scale.
Results: Eleven studies with 233 patients and 432 CLNM were analyzed. The pooled VRR was 95.24% [95% Confidence Interval (CI): 91.97- 98.51%], complete disappearance was 63.1%, and recurrence was 1.6%. Changes in largest diameter, volume, and serum Tg were 8.36 mm (95%CI: 6.46-10.26mm), 216.09mm³, and 6.12ng/ml, respectively. Major complications occurred at 3.0%, while minor complications were 25.6%. Significant heterogeneity was found for diameter, volume, VRR, Tg, and minor complications. Subgroup analysis showed that MWA had a higher VRR (97.18%) than RFA (93.84%) (P < 0.001).
Conclusion: Both RFA and MWA were effective and safe for treating CLNM from PTC. However, RFA showed lower volume reduction than MWA with significant heterogeneity in VRR.
Data availability statement: The original contributions revealed in the study are included in the article/Supplemental Material. Further inquiries can be made to the corresponding author.
期刊介绍：
Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.
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