Department of Ultrasound, China-Japan Union Hospital of Jilin University, No. 126, Xian Tai Street, Changchun, Jilin, 130033, China.
Eur Radiol. 2024 Jan;34(1):715-723. doi: 10.1007/s00330-023-10117-0. Epub 2023 Aug 15.
Microwave ablation (MWA) has achieved excellent long-term efficacy in treating unifocal papillary thyroid microcarcinoma (UPTMC). The therapeutic effect of this treatment on multifocal papillary thyroid microcarcinoma (MPTMC) is unknown. Therefore, we evaluated the long-term efficacy of MWA for low-risk MPTMC and to provide evidence-based medicine for the revision of clinical guidelines.
This study included 66 MPTMC patients with a total of 158 lesions, all of whom received MWA. We collected and retrospectively analyzed the patients' follow-up data before MWA, at 1, 3, 6, and 12 months posttreatment and every 6 months thereafter until 5 years posttreatment. We evaluated the MWA complication rate, technical success rate (TSR), lesion volume reduction rate (VRR), and complete disappearance rate (CDR) during follow-up and in those patients with tumor progression and delayed surgery.
After 60 months of follow-up, all 158 lesions disappeared in 66 patients, and the volume was reduced from 43.82 mm to 0.00 mm. The TSR and VRR were both 100%. The CDRs at 1 year, 2 years, and 3 years were 57.59%, 93.67%, and 100%, respectively. The complication rate was 3.03% (2/66), and the incidence of tumor progression was 3.03% (2/66), including one new intrathyroidal lesion and one cervical lymph node metastasis (LNM). These lesions were retreated with MWA, and the lesions disappeared during the follow-up period.
Ultrasound-guided MWA for low-risk MPTMC is safe and effective and may serve as an alternative option for patients who refuse surgery or active surveillance (AS).
This study concludes that ultrasound-guided microwave ablation for low-risk multifocal papillary thyroid microcarcinoma is safe and effective and may serve as an alternative option for patients who refuse surgery or active surveillance.
• Ultrasound-guided microwave ablation for low-risk multifocal papillary thyroid microcarcinoma is safe and effective. • During 5 years of follow-up, multifocal papillary thyroid microcarcinoma patients treated with microwave ablation had a favorable prognosis. • To provide evidence-based medicine for the revision of clinical guidelines.
微波消融（MWA）在治疗单发甲状腺微小乳头状癌（UPTMC）方面取得了优异的长期疗效。但对于多灶性甲状腺微小乳头状癌（MPTMC）的治疗效果尚不清楚。因此，我们评估了 MWA 治疗低危 MPTMC 的长期疗效，为临床指南的修订提供循证医学依据。
本研究纳入了 66 例 MPTMC 患者共 158 个病灶，均接受 MWA 治疗。我们收集并回顾性分析了患者 MWA 治疗前、治疗后 1、3、6 和 12 个月以及此后每 6 个月的随访资料，直至 5 年。我们评估了随访期间及肿瘤进展和延迟手术患者的 MWA 并发症发生率、技术成功率（TSR）、病灶体积缩小率（VRR）和完全消失率（CDR）。
60 个月随访后，66 例患者 158 个病灶全部消失，体积由 43.82mm 缩小至 0.00mm。TSR 和 VRR 均为 100%。1 年、2 年和 3 年的 CDR 分别为 57.59%、93.67%和 100%。并发症发生率为 3.03%（2/66），肿瘤进展发生率为 3.03%（2/66），包括 1 例新的甲状腺内病灶和 1 例颈部淋巴结转移（LNM）。这些病灶均采用 MWA 进行了再次治疗，在随访期间病灶消失。
超声引导下 MWA 治疗低危 MPTMC 安全有效，可能是拒绝手术或主动监测（AS）患者的一种替代选择。
本研究表明，超声引导下微波消融治疗低危多灶性甲状腺微小乳头状癌安全有效，可能是拒绝手术或主动监测患者的一种替代选择。
①超声引导下微波消融治疗低危多灶性甲状腺微小乳头状癌安全有效。②在 5 年随访期间，接受微波消融治疗的多灶性甲状腺微小乳头状癌患者预后良好。③为临床指南的修订提供循证医学依据。
