Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China.
Int J Hyperthermia. 2023;40(1):2266668. doi: 10.1080/02656736.2023.2266668. Epub 2023 Nov 8.
To analyze the outcomes of radiofrequency ablation (RFA) for isthmus papillary thyroid cancer (PTC) versus PTC originating from the lobes.
Patients with solitary low-risk PTC treated with RFA between July 2014 and December 2019 were retrospectively reviewed. This study was approved by our institutional review board. Of the 562 patients, 104 and 458 had PTCs located in the thyroid isthmus and thyroid lobes, respectively. Local tumor progression (LTP), LTP-free survival (LTPFS), changes in tumor volume, and complications were compared between the two groups using propensity-score matching (PSM).
The isthmic and lobar groups showed no significant differences in LTP (2.9% vs. 3.8%), new PTC (2.9% vs. 2.9%), persistent lesions (0.0% vs. 0.2%), or LTPFS after PSM. Before PSM, the two groups showed significant differences in the volume reduction ratio (VRR) of the ablated tumors at 1, 3, 24, 30, and 48 months after RFA, but no differences between the two groups were observed in tumor volume, VRR, or disappearance rate after PSM ( > .05). One patient in the isthmic group presented with coughing, while another complained of hoarseness. Complications did not differ significantly between the two groups ( > .05).
The outcomes of RFA for patients with low-risk PTC in the thyroid isthmus and thyroid lobes were similar. Therefore, RFA may serve as an alternative treatment option for patients with low-risk isthmic PTC.
分析射频消融（RFA）治疗峡部甲状腺乳头状癌（PTC）与起源于叶部的 PTC 的疗效。
回顾性分析了 2014 年 7 月至 2019 年 12 月期间接受 RFA 治疗的 562 例单发低危 PTC 患者的资料。本研究经我院伦理委员会批准。其中 104 例（18.5%）PTC 位于甲状腺峡部，458 例（81.5%）位于甲状腺叶。采用倾向性评分匹配（PSM）比较两组患者的局部肿瘤进展（LTP）、LTP 无进展生存率（LTPFS）、肿瘤体积变化及并发症。
PSM 前，两组患者 LTP（2.9% vs. 3.8%）、新发 PTC（2.9% vs. 2.9%）、残留病灶（0.0% vs. 0.2%）或 LTPFS 差异均无统计学意义。PSM 后，两组患者肿瘤体积、VRR 及消失率差异均无统计学意义（ > .05）。RFA 后 1、3、24、30 和 48 个月，两组患者消融灶体积缩小率（VRR）差异有统计学意义。峡部组有 1 例患者出现咳嗽，1 例患者出现声音嘶哑，两组并发症发生率差异无统计学意义（ > .05）。
对于低危 PTC 患者，RFA 治疗甲状腺峡部和叶部的疗效相似。因此，RFA 可能是低危峡部 PTC 患者的一种替代治疗选择。
