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T1aN0M0与T1bN0M0孤立性乳头状甲状腺癌射频消融的临床结局:一项倾向匹配队列研究

Clinical outcomes of radiofrequency ablation for solitary T1aN0M0 versus T1bN0M0 papillary thyroid carcinoma: a propensity-matched cohort study.

作者信息

Tong Mengying, Wang Linchun, Gai Ziru, Zhu Yalin, Che Ying

机构信息

Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, P.R. China.

出版信息

Int J Hyperthermia. 2023;40(1):2257908. doi: 10.1080/02656736.2023.2257908. Epub 2023 Oct 17.

DOI:10.1080/02656736.2023.2257908
PMID:37848402
Abstract

OBJECTIVE

To conduct a cohort study comparing the treatment outcomes of radiofrequency ablation (RFA) therapy for solitary T1aN0M0 (T1a) versus T1bN0M0 (T1b) papillary thyroid carcinoma (PTC).

METHODS

This retrospective analysis comprised 310 patients with low-risk PTC undergoing RFA classified into T1a ( = 272) and T1b ( = 38) groups according to the tumor size. A comparative analysis between the two groups was conducted for the volume reduction ratio (VRR), volume, local tumor progression (LTP), and recurrence-free survival (RFS) before and after 1:2 propensity score matching (PSM). Cox analysis was conducted to examine the influence of several variables, including T1b, on recurrence following RFA for PTC.

RESULTS

The total VRR was 99.99 ± 0.11% throughout the median follow-up duration of 26 months, and the overall incidence of LTP was 2.58% (8/310). No irrecoverable complications occurred after RFA. The variations between the T1a and T1b groups following PSM were insignificant in terms of volume ( = 0.574), VRR ( = 0.574), complete disappearance rate ( = 0.210), LTP incidence ( = 1.000), and RFS rate ( = 0.610). The correlation between T1b and LTP continued to be insignificant ( = 0.686). No distant metastasis or delayed surgery occurred.

CONCLUSIONS

The presence of T1b did not influence the patients' prognoses following RFA for T1N0M0 PTC. After appropriate patient selection and adequate preoperative assessment, RFA has the potential to serve as an effective therapy for individuals with T1a and T1b PTC.

摘要

目的

开展一项队列研究,比较射频消融(RFA)治疗孤立性T1aN0M0(T1a)与T1bN0M0(T1b)乳头状甲状腺癌(PTC)的治疗效果。

方法

这项回顾性分析纳入了310例接受RFA治疗的低风险PTC患者,根据肿瘤大小分为T1a组(n = 272)和T1b组(n = 38)。在1:2倾向评分匹配(PSM)前后,对两组的体积缩小率(VRR)、体积、局部肿瘤进展(LTP)和无复发生存期(RFS)进行比较分析。进行Cox分析以检验包括T1b在内的多个变量对PTC患者RFA术后复发的影响。

结果

在26个月的中位随访期内,总体VRR为99.99±0.11%,LTP的总体发生率为2.58%(8/310)。RFA术后未发生不可恢复的并发症。PSM后,T1a组和T1b组在体积(P = 0.574)、VRR(P = 0.574)、完全消失率(P = 0.210)、LTP发生率(P = 1.000)和RFS率(P = 0.610)方面的差异均无统计学意义。T1b与LTP之间的相关性仍无统计学意义(P = 0.686)。未发生远处转移或延迟手术。

结论

T1b的存在并不影响T1N0M0 PTC患者RFA术后的预后。经过适当的患者选择和充分的术前评估,RFA有可能成为T1a和T1b PTC患者的有效治疗方法。

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