Yan Lin, Yang Zhen, Jing Haoyu, Xiao Jing, Li Yingying, Li XinYang, Zhang Mingbo, Luo Yukun
Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China.
Eur Radiol. 2025 Jan 21. doi: 10.1007/s00330-024-11286-2.
To compare the clinical outcomes between radiofrequency ablation (RFA) and microwave ablation (MWA) for the treatment of T1N0M0 papillary thyroid carcinoma (PTC) in a large cohort.
This retrospective study included 1111 patients with solitary T1N0M0 PTC treated with RFA (n = 894) or MWA (n = 215) by experienced physicians. A propensity score matching was used to compare disease progression, including lymph node metastases (LNM), recurrent tumors and persistent tumors, recurrence-free survival (RFS), volume reduction ratio (VRR), and complications between the RFA and MWA groups. The subgroup outcomes of T1a and T1b tumors treated with RFA and MWA were also compared.
During a mean follow-up period of 41.7 ± 12.6 months, the overall incidence rates of disease progression, LNM, recurrent tumors, and persistent tumors were 2.1%, 0.7%, 1.2%, and 0.2%, respectively. Eight patients (0.7%) experienced transient voice change and recovered within 3 months. After 1:1 matching, there were no significant differences in disease progression (3.3% vs. 3.7%, p = 0.793), LNM (1.4% vs. 1.9%, p = 1.000), recurrent tumor (1.4% vs. 1.9%, p = 1.000), persistent tumors (0.5% vs. 0%, p = 0.317), RFS rates (96.7% vs. 96.3%, p = 0.821), VRR (99.3 ± 3.0% vs. 98.3 ± 8.5%, p = 0.865), tumor disappearance rate (87.9% vs. 81.4%, p = 0.061) and complications (1.4% vs. 1.9%, p = 1.000) between the RFA and MWA groups. For T1a and T1b tumors, clinical outcomes were comparable between RFA and MWA.
RFA and MWA did not show significant differences in clinical outcomes for T1N0M0 PTC. The choice between RFA and MWA could depend on physician expertise and resources of local center resources. A qualified and experienced physician with extensive knowledge of the modalities is recommended when thermal ablation is performed.
Question With radiofrequency ablation (RFA) and microwave ablation (MWA) used worldwide for T1N0M0 papillary thyroid carcinoma (PTC), is one of them superior to the others? Findings There were no significant differences in disease progression, recurrence-free survival, volume reduction ratio, tumor disappearance, or complications between techniques for solitary T1N0M0 papillary thyroid carcinoma. Clinical relevance The choice between RFA and MWA could depend on physician expertise and resources of the local center resources. A qualified and experienced physician with extensive knowledge of the modalities is recommended when thermal ablation is performed.
在一个大型队列中比较射频消融（RFA）和微波消融（MWA）治疗T1N0M0乳头状甲状腺癌（PTC）的临床结局。
这项回顾性研究纳入了1111例接受RFA（n = 894）或MWA（n = 215）治疗的孤立性T1N0M0 PTC患者，治疗由经验丰富的医生进行。采用倾向评分匹配法比较RFA组和MWA组之间的疾病进展情况，包括淋巴结转移（LNM）、复发肿瘤和持续性肿瘤、无复发生存率（RFS）、体积缩小率（VRR）以及并发症。还比较了RFA和MWA治疗T1a和T1b肿瘤的亚组结局。
在平均41.7±12.6个月的随访期内，疾病进展、LNM、复发肿瘤和持续性肿瘤的总体发生率分别为2.1%、0.7%、1.2%和0.2%。8例患者（0.7%）出现短暂声音改变，并在3个月内恢复。1:1匹配后，RFA组和MWA组在疾病进展（3.3%对3.7%，p = 0.793）、LNM（1.4%对1.9%，p = 1.000）、复发肿瘤（1.4%对1.9%，p = 1.000）、持续性肿瘤（0.5%对0%，p = 0.317）、RFS率（96.7%对96.3%，p = 0.821）、VRR（99.3±3.0%对98.3±8.5%，p = 0.865）、肿瘤消失率（87.9%对81.4%，p = 0.061）及并发症（1.4%对1.9%，p = 1.000）方面均无显著差异。对于T1a和T1b肿瘤，RFA和MWA的临床结局相当。
对于T1N0M0 PTC，RFA和MWA在临床结局上未显示出显著差异。RFA和MWA之间的选择可能取决于医生的专业技能和当地中心的资源情况。进行热消融时，建议选择一位对这些技术有广泛了解的合格且经验丰富的医生。
问题 射频消融（RFA）和微波消融（MWA）在全球范围内用于T1N0M0乳头状甲状腺癌（PTC），其中一种是否优于其他方法？ 发现 对于孤立性T1N0M0乳头状甲状腺癌，不同技术在疾病进展、无复发生存率、体积缩小率、肿瘤消失或并发症方面无显著差异。 临床意义 RFA和MWA之间的选择可能取决于医生的专业技能和当地中心的资源情况。进行热消融时，建议选择一位对这些技术有广泛了解的合格且经验丰富的医生。
