Liu Yu-Tong, Wei Ying, Zhao Zhen-Long, Wu Jie, Cao Shi-Liang, Yu Na, Li Yan, Peng Li-Li, Yu Ming-An
China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (Y.T.L.).
Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China (Y.W., Z.L.Z., J.W., S.L.C., N.Y., Y.L., L.L.P., M.Y.).
Acad Radiol. 2025 Jul;32(7):3915-3923. doi: 10.1016/j.acra.2025.03.019. Epub 2025 Mar 31.
Thermal ablation (TA) has demonstrated promising treatment efficacy and safety in T1N0M0 papillary thyroid carcinoma (PTC). However, the efficacy and safety of TA for T2N0M0 PTC still lack sufficient evidence.
To compare the technical effectiveness, disease progression, and complications of TA in the treatment of solitary T1N0M0 versus solitary T2N0M0 PTC.
In this retrospective study, 1159 patients with PTC treated with TA from January 2015 to June 2024 were included and divided into two groups according to tumor stage. Propensity score matching (PSM) was used to control for confounding factors. Kaplan-Meier curves were used to analyze the disease progression.
After PSM (1:4), 41 patients (median age 35 years [IQR 30-49]; 30 women) were included in the T2 group, and 164 patients (median age 34 years [IQR 29-43]; 108 women) were included in the T1 group. The median follow-up durations were 26 months (IQR 13-49) for the T2 group and 25 months (IQR 12.3-43) for the T1 group. The technical success rates were 100% in the two groups. Statistical analysis showed no significant differences in disease progression between the T1 and T2 groups (0.6% vs. 4.9%, P=0.103), nor in disease progression-free survival rates (98.2% vs. 88.6%, log-rank P=0.052). The incidence of major complications was higher in the T2 group than that in the T1 group (1.8% vs. 17.1%, P=0.001). No permanent hoarseness was observed in the two groups.
TA could be a safe and effective option in the treatment of solitary T2N0M0 PTC. No significant difference was observed in disease progression between T1N0M0 and T2N0M0 PTC.
热消融（TA）已在T1N0M0乳头状甲状腺癌（PTC）的治疗中展现出有前景的治疗效果和安全性。然而，TA治疗T2N0M0 PTC的疗效和安全性仍缺乏充分证据。
比较TA治疗孤立性T1N0M0与孤立性T2N0M0 PTC的技术有效性、疾病进展及并发症情况。
在这项回顾性研究中，纳入了2015年1月至2024年6月期间接受TA治疗的1159例PTC患者，并根据肿瘤分期分为两组。采用倾向评分匹配（PSM）来控制混杂因素。使用Kaplan-Meier曲线分析疾病进展情况。
经过PSM（1:4）后，T2组纳入41例患者（中位年龄35岁[四分位间距30 - 49]；30例女性），T1组纳入164例患者（中位年龄34岁[四分位间距29 - 43]；108例女性）。T2组的中位随访时间为26个月（四分位间距13 - 49），T1组为25个月（四分位间距12.3 - 43）。两组的技术成功率均为100%。统计分析显示，T1组和T2组之间的疾病进展无显著差异（0.6%对4.9%，P = 0.103），无疾病进展生存率也无显著差异（98.2%对88.6%，对数秩检验P = 0.052）。T2组的主要并发症发生率高于T1组（1.8%对17.1%，P = 0.001）。两组均未观察到永久性声音嘶哑。
TA可能是治疗孤立性T2N0M0 PTC的一种安全有效的选择。T1N0M0和T2N0M0 PTC之间在疾病进展方面未观察到显著差异。
