Zhao Han-Xiao, Wei Ying, Zhao Zhen-Long, Peng Li-Li, Li Yan, Wu Jie, Cao Shi-Liang, Yu Na, Yu Ming-An
China-Japan Friendship Institute of Clinical Medical Sciences, Beijing, China.
Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China.
Eur Radiol. 2025 Mar;35(3):1714-1722. doi: 10.1007/s00330-024-11210-8. Epub 2024 Nov 27.
This study aimed to evaluate the long-term efficacy and safety of microwave ablation (MWA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) and compare them between T1a and T1b disease.
This retrospective study included 136 patients with solitary T1N0M0 PTC who were treated with MWA and followed up for more than 5 years. Outcomes were compared between patients with T1a and T1b disease. The primary outcomes were disease progression and disease-free survival (DFS). The secondary outcomes included the volume reduction rate (VRR), the rate of complete disappearance, and complications.
During a mean follow-up period of 70.6 ± 10.5 months, the overall disease progression rate was 5.88%. The incidences of lymph node metastases (LNMs) and new tumors were 2.21% and 5.15%, respectively. No patient was diagnosed with local recurrence, distant metastasis, or death due to PTC. There were no significant differences between the T1a and T1b groups in terms of disease progression (3.81% vs 12.90%, p = 0.15), LNMs (1.90% vs 3.23%, p = 0.54), or new tumors (2.86% vs 12.90%, p = 0.08). The 5-year DFS rate was 94.85%, the VRR was 99.7% ± 2.0%, and 97.79% of the tumors disappeared. Hoarseness occurred in five patients (3.68%).
MWA is a long-term effective and safe option for patients with solitary T1N0M0 PTC, providing a minimally invasive alternative for those who refuse surgery or active surveillance.
Question MWA, as a minimally invasive alternative for treating PTC, lacks comparison with surgical resection and active surveillance. Findings MWA resulted in overall disease progression in 5.88% of patients with solitary T1N0M0 PTC over more than 5 years of follow-up. Clinical relevance MWA is a safe, effective, and minimally invasive treatment for solitary T1N0M0 PTC, with high DFS rates and low complication rates, benefiting patients seeking alternatives to surgery or active surveillance.
本研究旨在评估微波消融（MWA）治疗孤立性T1N0M0乳头状甲状腺癌（PTC）的长期疗效和安全性，并比较T1a期和T1b期疾病的疗效和安全性。
这项回顾性研究纳入了136例接受MWA治疗并随访超过5年的孤立性T1N0M0 PTC患者。比较T1a期和T1b期患者的结局。主要结局为疾病进展和无病生存期（DFS）。次要结局包括体积缩小率（VRR）、完全消失率和并发症。
在平均70.6±10.5个月的随访期内，总体疾病进展率为5.88%。淋巴结转移（LNM）和新肿瘤的发生率分别为2.21%和5.15%。没有患者被诊断为局部复发、远处转移或因PTC死亡。T1a组和T1b组在疾病进展（3.81%对12.90%，p=0.15）、LNM（1.90%对3.23%，p=0.54）或新肿瘤（2.86%对12.90%，p=0.08）方面没有显著差异。5年DFS率为94.85%，VRR为99.7%±2.0%，97.79%的肿瘤消失。5例患者（3.68%）出现声音嘶哑。
对于孤立性T1N0M0 PTC患者，MWA是一种长期有效且安全的选择，为那些拒绝手术或主动监测的患者提供了一种微创替代方案。
问题MWA作为治疗PTC的微创替代方案，缺乏与手术切除和主动监测的比较。发现MWA导致5.88%的孤立性T1N0M0 PTC患者在超过5年的随访中出现总体疾病进展。临床意义MWA是治疗孤立性T1N0M0 PTC的一种安全、有效且微创的治疗方法，DFS率高，并发症发生率低，可以使寻求手术或主动监测替代方案的患者受益。
