Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China.
Int J Hyperthermia. 2022;39(1):372-378. doi: 10.1080/02656736.2022.2040607.
To evaluate the feasibility, efficiency, and safety of microwave ablation (MWA) for T1N0M0 papillary thyroid carcinoma (PTC) with capsular invasion (CI).
The data of 69 T1N0M0 PTC with CI underwent MWA from August 2015 to January 2020 were retrospectively analyzed. All PTC nodules were pathologically confirmed by fine needle aspiration (FNA). The extended ablation was performed in all cases, that is, the ablation zone completely covered the tumor and extended the tumor edge by at least 2 mm. The strategy of fluid isolation was successfully applied before and during ablation. The strategy of multiple point ablation was applied. After ablation, the changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis (LNM), and complications were evaluated and recorded. The technical feasibility, technical success rate, and safety were analyzed.
Based on the contrast-enhanced ultrasound results, complete ablation has been achieved in all enrolled cases after ablation. The mean maximum tumor diameter and the mean volume of PTC nodules before ablation were 0.84 ± 0.39 cm (range, 0.3-2 cm) and 0.26 ± 0.35 ml (range, 0.01-1.72 ml) respectively. The mean follow-up time was 26 ± 10 months (range, 9-48 months). Nodules in 47 cases (68.1%) completely disappeared in the follow-up period. No local recurrence was detected. The incidence of new lesions and LNM was 4.3% (3/69) and 4.3% (3/69) respectively. Further ablations have been successfully employed for all of the new lesions and LMN. Light voice changes (2.9%, 2/69) were the only major complication, which was relieved within 6 months after MWA. The sizes of the ablation zone increased firstly within 6 months after MWA compared with the pretreatment tumor size ( < 0.05). Twelve months later, the sizes were smaller than those before MWA ( < 0.05 for all).
MWA is an effective, safe, and feasible method in treating T1N0M0 PTC with CI.
评估微波消融（MWA）治疗伴有包膜侵犯（CI）的 T1N0M0 甲状腺乳头状癌（PTC）的可行性、效率和安全性。
回顾性分析了 2015 年 8 月至 2020 年 1 月期间 69 例 T1N0M0 PTC 伴 CI 行 MWA 治疗的患者资料。所有 PTC 结节均经细针穿刺抽吸活检（FNA）病理证实。所有病例均行扩展消融，即消融区完全覆盖肿瘤，并向肿瘤边缘至少扩展 2mm。在消融前和消融过程中成功应用了液性隔离策略。应用多点消融策略。消融后，评估并记录不同时间点肿瘤大小变化、局部复发、新发病灶、淋巴结转移（LNM）和并发症情况，并记录分析技术的可行性、技术成功率和安全性。
根据增强超声结果，消融后所有患者均达到完全消融。消融前，最大肿瘤直径的平均值为 0.84±0.39cm（范围，0.3-2cm），PTC 结节的平均体积为 0.26±0.35ml（范围，0.01-1.72ml）。平均随访时间为 26±10 个月（范围，9-48 个月）。47 例（68.1%）患者的结节在随访期间完全消失。未发现局部复发。新发病灶和 LNM 的发生率分别为 4.3%（3/69）和 4.3%（3/69）。所有新发病灶和 LNM 均成功进行了进一步消融。仅 2.9%（2/69）的患者出现轻度声音改变，MWA 后 6 个月内缓解。MWA 后 6 个月内，消融区大小较治疗前肿瘤大小先增大（ < 0.05），12 个月后，消融区大小较 MWA 前缩小（均 < 0.05）。
MWA 是治疗伴有 CI 的 T1N0M0 PTC 的一种有效、安全、可行的方法。
