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超过三年的甲状腺乳头状癌热消融治疗随访结果:系统回顾和荟萃分析。

Over than three-year follow-up results of thermal ablation for papillary thyroid carcinoma: A systematic review and meta-analysis.

机构信息

Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, China.

出版信息

Front Endocrinol (Lausanne). 2022 Oct 24;13:971038. doi: 10.3389/fendo.2022.971038. eCollection 2022.

Abstract

BACKGROUND

This study is a meta-analysis based on evidence-based medicine to explore the long-term (≥3 years) efficacy of thermal ablation in the treatment of papillary thyroid carcinoma (PTC).

METHODS

We searched the PubMed, Embase, and Cochrane Library databases for studies published during the time between the establishment of the databases through June 2022. We included 13 non-randomized-controlled trials (non-RCTs) that reported the application of ultrasound-guided thermal ablation in PTC. We excluded studies that were repeated publications, research without full text, contained incomplete information, lacked data extraction, involved animal experiments, reviews, and systematic reviews. STATA 15.1 software was used to analyze the data.

RESULTS

Tumor volume after thermal ablation at 3-year follow-up was significantly lower than pre-ablation (standardized mean difference [SMD] = -1.06, 95% CI: -1.32-0.80). The pooled results indicated that the maximum diameter after thermal ablation at 3-year follow-up was significantly lower than pre-ablation (SMD = -1.93, 95% CI: -12.13-1.73). The pooled results indicated that volume reduction rate (VRR) after thermal ablation at 3-year follow-up was 98.91% (95% CI: 97.98-99.83%), and complete disappearance rate (CDR) after thermal ablation at 3-year follow-up was 83% (95% CI: 67-94%). In addition, the incidence of newly discovered mPTC and lymph node metastases after thermal ablation was 0.3% (95% CI: 0.0-1.0%) and 0.0% (95% CI: 0.0-0.0%), respectively.

CONCLUSION

Overall, the long-term (≥3 years) efficacy of ultrasound-guided thermal ablation in the treatment of PTC was significant, with favorable disease progression. Ultrasound-guided thermal ablation can be considered an alternative approach for patients with PTC who refuse surgery or are unable to undergo surgery.

摘要

背景

本研究是一项基于循证医学的荟萃分析,旨在探讨热消融治疗甲状腺乳头状癌(PTC)的长期(≥3 年)疗效。

方法

我们检索了 PubMed、Embase 和 Cochrane Library 数据库,纳入了自数据库建立以来至 2022 年 6 月期间发表的报告超声引导下热消融治疗 PTC 的 13 项非随机对照试验(non-RCTs)。排除了重复发表的研究、无全文的研究、信息不完整的研究、缺乏数据提取的研究、涉及动物实验的研究、综述和系统评价。采用 STATA 15.1 软件进行数据分析。

结果

3 年随访时消融后肿瘤体积明显低于消融前(标准化均数差 [SMD] = -1.06,95%置信区间:-1.32-0.80)。汇总结果表明,3 年随访时消融后最大直径明显低于消融前(SMD = -1.93,95%置信区间:-12.13-1.73)。汇总结果表明,3 年随访时消融后的体积缩小率(VRR)为 98.91%(95%置信区间:97.9899.83%),消融后 3 年的完全消失率(CDR)为 83%(95%置信区间:6794%)。此外,消融后新发现微小甲状腺癌(mPTC)和淋巴结转移的发生率分别为 0.3%(95%置信区间:0.01.0%)和 0.0%(95%置信区间:0.00.0%)。

结论

总体而言,超声引导下热消融治疗 PTC 的长期(≥3 年)疗效显著,疾病进展良好。对于拒绝手术或无法手术的 PTC 患者,超声引导下热消融可作为一种替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa39/9637737/13c4decbcfba/fendo-13-971038-g001.jpg

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