Yue Wen-Wen, Wang Shu-Rong, Lu Feng, Sun Li-Ping, Guo Le-Hang, Zhang Yong-Lin, Li Xiao-Long, Xu Hui-Xiong
Department of Medical Ultrasound, Tenth People's Hospital of Tongji University, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, 200072, China.
Department of Medical Ultrasound, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, Shandong, 264100, China.
Endocrine. 2017 Feb;55(2):485-495. doi: 10.1007/s12020-016-1173-5. Epub 2016 Nov 30.
To compare the efficacy and the safety of radiofrequency ablation and microwave ablation for treatment of benign thyroid nodules using a propensity score matching study design.
Two hundred and sixty patients with benign thyroid nodules were studied retrospectively, including 102 patients treated with radiofrequency ablation and 158 treated with microwave ablation. To reduce confounding bias due to retrospective assignment, propensity score matching was performed to balance the preablation data of the two groups. After matching, a total of 102 patient pairs (1:1) were created. The volume reduction ratio, therapeutic success rate, symptom and cosmetic score, and major complication were compared between the two groups at 1, 3, 6, and 12 months after treatment.
Between the well-matched groups, no significant differences were found in all nodule volume-related end points at 6 months (volume reduction ratio: 79.4 vs. 77.2 %, P = 0.108; symptom score: 2.1 vs. 1.9, P = 0.456; cosmetic score: 2.1 vs. 2.3, P = 0.119; therapeutic success rate: 99 vs. 97 %, P = 0.621) and 12 months (volume reduction ratio: 83.6 vs. 81.6 %, P = 0.144; symptom score: 1.5 vs. 1.5, P = 0.869; cosmetic score: 1.6 vs. 1.7, P = 0.409; therapeutic success rate: 100 vs. 100 %, P > 0.99) after treatment. No major complications occurred in either group (P > 0.99).
With well-matched groups and consistent procedure design, our results demonstrated that the volume reduction ratio, therapeutic success rate, symptom and cosmetic score, and complications related to treatment for the two techniques are equivalent. Radiofrequency ablation and microwave ablation are both effective and safe methods in treating benign thyroid nodules.
采用倾向评分匹配研究设计,比较射频消融和微波消融治疗良性甲状腺结节的疗效和安全性。
回顾性研究260例良性甲状腺结节患者,其中102例接受射频消融治疗,158例接受微波消融治疗。为减少回顾性分配导致的混杂偏倚,进行倾向评分匹配以平衡两组消融前的数据。匹配后,共创建了102对患者(1:1)。比较两组在治疗后1、3、6和12个月时的体积缩小率、治疗成功率、症状和美容评分以及主要并发症。
在匹配良好的组间,治疗后6个月时所有与结节体积相关的终点指标均无显著差异(体积缩小率:79.4%对77.2%,P = 0.108;症状评分:2.1对1.9,P = 0.456;美容评分:2.1对2.3,P = 0.119;治疗成功率:99%对97%,P = 0.621),12个月时也无显著差异(体积缩小率:83.6%对81.6%,P = 0.144;症状评分:1.5对1.5,P = 0.869;美容评分:1.6对1.7,P = 0.409;治疗成功率:100%对100%,P > 0.99)。两组均未发生主要并发症(P > 0.99)。
在匹配良好的组和一致的操作设计下,我们的结果表明,两种技术的体积缩小率、治疗成功率、症状和美容评分以及与治疗相关的并发症相当。射频消融和微波消融都是治疗良性甲状腺结节的有效且安全的方法。