Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Int J Hyperthermia. 2023 Dec;40(1):2244713. doi: 10.1080/02656736.2023.2244713.
BACKGROUND: To analyze the efficacy and safety of radiofrequency ablation (RFA), microwave ablation (MWA) and laser ablation (LA) in T1N0M0 papillary thyroid carcinoma (PTC) patients by evaluating data on several outcomes on a large scale. MATERIALS AND METHODS: Literature searches were conducted in PUBMED, EMBASE and the Cochrane Library for studies of thermal ablation (TA) for treating T1N0M0 PTC. Data on the volume reduction rate (VRR) at the 12-month follow-up and final follow-up, complete disappearance rate, local recurrence rate, lymph node metastasis rate, and complication rate of RFA, MWA and LA were evaluated separately. RFA effects were compared between T1aN0M0 and T1bN0M0 patients. RESULTS: A total of 36 eligible studies were included. RFA presented superior efficacy than MWA in 12-month VRR. At the final follow-up, the difference was slight in subgroups, showing a significant reduction. The complete disappearance rate of LA (93.00%) was higher than that of RFA (81.00%) and MWA (71.00%). Additionally, the local recurrence rate pooled proportions of MWA and RFA were both 2.00%, lower than that of the LA group (3.00%). There was no event of distant metastasis. The lymph node metastasis rates were similar, as RFA (1.00%) had the lowest. For minor complication rates, the pooled proportions of RFA (3.00%) were smaller than those of LA (6.00%) and MWA (13.00%). T1aN0M0 lesions presented with better outcomes than T1bN0M0 lesions. CONCLUSION: RFA, MWA and LA were reliable in curing PTC, and RFA presented advantages in most outcomes. T1aN0M0 patients may experience fewer side effects than T1bN0M0 patients.
背景:通过评估大规模多项结局数据,分析射频消融(RFA)、微波消融(MWA)和激光消融(LA)治疗 T1N0M0 甲状腺乳头状癌(PTC)患者的疗效和安全性。
材料与方法:在 PUBMED、EMBASE 和 Cochrane 图书馆中对热消融(TA)治疗 T1N0M0 PTC 的研究进行文献检索。分别评估 RFA、MWA 和 LA 在 12 个月随访和最终随访时的体积缩小率(VRR)、完全消失率、局部复发率、淋巴结转移率和并发症发生率的数据。比较 T1aN0M0 和 T1bN0M0 患者 RFA 的疗效。
结果:共纳入 36 项符合条件的研究。RFA 在 12 个月时的 VRR 优于 MWA。在最终随访时,亚组间差异较小,呈显著降低。LA 的完全消失率(93.00%)高于 RFA(81.00%)和 MWA(71.00%)。此外,MWA 和 RFA 的局部复发率合并比例均为 2.00%,低于 LA 组(3.00%)。无远处转移事件。淋巴结转移率相似,RFA(1.00%)最低。对于轻微并发症发生率,RFA 的合并比例(3.00%)小于 LA(6.00%)和 MWA(13.00%)。T1aN0M0 病变的疗效优于 T1bN0M0 病变。
结论:RFA、MWA 和 LA 均能可靠治疗 PTC,RFA 在大多数结局方面具有优势。T1aN0M0 患者的不良反应可能少于 T1bN0M0 患者。
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