Clinical outcomes of microwave ablation for solitary T1N0M0 papillary thyroid carcinoma: a more than 5-year follow-up study

Han-Xiao Zhao; Ying Wei; Zhen-Long Zhao; Li-Li Peng; Yan Li; Jie Wu; Shi-Liang Cao; Na Yu; Ming-An Yu

doi:10.1007/s00330-024-11210-8

Clinical outcomes of microwave ablation for solitary T1N0M0 papillary thyroid carcinoma: a more than 5-year follow-up study

Eur Radiol. 2024 Nov 27. doi: 10.1007/s00330-024-11210-8. Online ahead of print.

Authors

Han-Xiao Zhao^{1

2}, Ying Wei², Zhen-Long Zhao², Li-Li Peng², Yan Li², Jie Wu², Shi-Liang Cao², Na Yu², Ming-An Yu³

Affiliations

¹ China-Japan Friendship Institute of Clinical Medical Sciences, Beijing, China.
² Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China.
³ Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China. yma301@163.com.

PMID: 39601831
DOI: 10.1007/s00330-024-11210-8

Abstract

Objectives: This study aimed to evaluate the long-term efficacy and safety of microwave ablation (MWA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) and compare them between T1a and T1b disease.

Materials and methods: This retrospective study included 136 patients with solitary T1N0M0 PTC who were treated with MWA and followed up for more than 5 years. Outcomes were compared between patients with T1a and T1b disease. The primary outcomes were disease progression and disease-free survival (DFS). The secondary outcomes included the volume reduction rate (VRR), the rate of complete disappearance, and complications.

Results: During a mean follow-up period of 70.6 ± 10.5 months, the overall disease progression rate was 5.88%. The incidences of lymph node metastases (LNMs) and new tumors were 2.21% and 5.15%, respectively. No patient was diagnosed with local recurrence, distant metastasis, or death due to PTC. There were no significant differences between the T1a and T1b groups in terms of disease progression (3.81% vs 12.90%, p = 0.15), LNMs (1.90% vs 3.23%, p = 0.54), or new tumors (2.86% vs 12.90%, p = 0.08). The 5-year DFS rate was 94.85%, the VRR was 99.7% ± 2.0%, and 97.79% of the tumors disappeared. Hoarseness occurred in five patients (3.68%).

Conclusion: MWA is a long-term effective and safe option for patients with solitary T1N0M0 PTC, providing a minimally invasive alternative for those who refuse surgery or active surveillance.

Key points: Question MWA, as a minimally invasive alternative for treating PTC, lacks comparison with surgical resection and active surveillance. Findings MWA resulted in overall disease progression in 5.88% of patients with solitary T1N0M0 PTC over more than 5 years of follow-up. Clinical relevance MWA is a safe, effective, and minimally invasive treatment for solitary T1N0M0 PTC, with high DFS rates and low complication rates, benefiting patients seeking alternatives to surgery or active surveillance.

Keywords: Ablation techniques; Disease progression; Thyroid neoplasms.

Abstract

Grants and funding