Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China.
Cancer. 2023 Aug 15;129(16):2469-2478. doi: 10.1002/cncr.34802. Epub 2023 Apr 15.
Ultrasound-guided radiofrequency ablation (RFA) has been used in patients with papillary thyroid carcinoma (PTC) who refuse surgery or active surveillance. However, the long-term outcomes are still limited. This study aimed to evaluate the clinical outcomes of RFA for solitary T1N0M0 PTC in a large cohort over a more than 5-year follow-up period.
This retrospective study included 358 patients with solitary T1N0M0 PTC who were treated with RFA and followed for at least 5 years. The bipolar RFA procedure was performed using hydrodissection technique, transisthmic approach, and moving-shot technique. The primary outcomes were disease progression, including lymph node metastasis (LNM), recurrent tumor, persistent tumor, and distant metastasis. The secondary outcomes were volume reduction rate, complete disappearance rate, complications, and delayed surgery.
During a mean follow-up period of 75.5 ± 9.7 months, the overall disease progression was 5.0%. The incidence of LNM, recurrent tumor, and persistent tumor was 1.4%, 3.1%, and 0.6%, respectively. There were no significant differences in the disease progression (5.0% vs. 5.5%, p = 1.000), LNM (1.3% vs. 1.8%, p = .568), recurrent tumor (3.3% vs. 1.8%, p = .872), persistent tumors (0.3% vs. 1.8%, p = .284), and 5-year recurrence-free survival rates (95.4% vs. 96.4%, p = .785) in the T1a and T1b groups. Volume reduction rate was 100.0 ± 0.3%, with 96.9% of tumors disappearing. No complications occurred. No patients underwent delayed surgery because of anxiety.
RFA is an effective and safe alternative for patients with T1N0M0 PTC and can offer a minimally invasive curative option for patients who refuse surgery or active surveillance.
During a mean follow-up period of 75.5 ± 9.7 months, the overall papillary thyroid carcinoma disease progression was 5.0%. The volume reduction rate was 100.0 ± 0.3%, with 96.9% of tumors disappearing. The T1a and T1b groups had similar incidence of disease progression and 5-year recurrence-free survival rates. No patients experienced complications or underwent delayed surgery because of anxiety.
对于拒绝手术或主动监测的甲状腺乳头状癌（PTC）患者，超声引导下射频消融（RFA）已被应用。然而，其长期疗效仍有限。本研究旨在评估在超过 5 年的随访期内，大样本接受 RFA 治疗的 T1N0M0 单发 PTC 患者的临床结局。
这是一项回顾性研究，共纳入 358 例接受 RFA 治疗且随访至少 5 年的 T1N0M0 单发 PTC 患者。采用水分离技术、经峡部入路和移动射击技术进行双极 RFA 手术。主要结局为疾病进展，包括淋巴结转移（LNM）、复发性肿瘤、持续性肿瘤和远处转移。次要结局为体积缩小率、完全消失率、并发症和延迟手术。
在平均 75.5±9.7 个月的随访期间，总疾病进展率为 5.0%。LNM、复发性肿瘤和持续性肿瘤的发生率分别为 1.4%、3.1%和 0.6%。疾病进展（5.0% vs. 5.5%，p=1.000）、LNM（1.3% vs. 1.8%，p=0.568）、复发性肿瘤（3.3% vs. 1.8%，p=0.872）、持续性肿瘤（0.3% vs. 1.8%，p=0.284）和 5 年无复发生存率（95.4% vs. 96.4%，p=0.785）在 T1a 和 T1b 组之间无显著差异。体积缩小率为 100.0±0.3%，96.9%的肿瘤完全消失。无并发症发生。无患者因焦虑而接受延迟手术。
RFA 是 T1N0M0 PTC 患者的一种有效且安全的替代治疗方法，可为拒绝手术或主动监测的患者提供一种微创的根治性选择。
