Lee Chih-Ying, Lin Wei-Che, Luo Sheng-Dean, Chiang Pi-Ling, Lin An-Ni, Wang Cheng-Kang, Chao Chun-Yuan
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Diagnostic Radiology, Kaohsiung Municipal Feng Shan Shen Hospital-Under the Management of Chang Gung Medical Foundation, Kaohsiung, Taiwan.
Korean J Radiol. 2025 May;26(5):460-470. doi: 10.3348/kjr.2024.0909.
To retrospectively compare the safety and efficacy of ultrasound-guided radiofrequency ablation (RFA) with parotidectomy for superficial pleomorphic adenoma (PA).
From March 2022 to October 2023, 88 patients diagnosed with superficial parotid PA underwent either RFA (n = 12; mean age, 47.1 years) or parotidectomy (n = 76; mean age, 47.8 years). Patients in the RFA group were matched to those in the surgery group in a 1:1 ratio using propensity scores based on age, sex, tumor volume, diameter, location, and comorbidities. Ultrasound characteristics, cosmetic scores (0-4), numerical rating scale scores (0-10), and complications were assessed before the procedures and at 1-, 3-, and 6-month follow-ups. Outcomes were compared between baseline and follow-up in the RFA group and between the RFA and surgery groups.
In the RFA group, significant reductions in tumor volume were observed between baseline (median, 2.02 cm³) and the 1-month follow-up (median, 1.21 cm³; = 0.015), between the 1-month and 3-month follow-ups (median, 0.53 cm³; = 0.002), and between the 3- and 6-month follow-ups (median, 0.23 cm³; = 0.003). The volume reduction ratios at 1, 3, and 6 months were 39.7%, 79.9%, and 88.0%, respectively. The cosmetic score was significantly lower at 3- and 6-month follow-up compared to baseline (median 1 and 1 vs. 4, = 0.04). The numerical rating scale scores did not differ significantly from baseline throughout follow-up. In the propensity score-matched analysis (12 patients per group), RFA was associated with a shorter median procedure time (61.5 vs. 253.3 minutes; < 0.001), shorter hospital stay (0 vs. 4 days; < 0.001), and lower cost (1859.9 vs. 3512.4 USD; < 0.001) than parotidectomy, with no significant difference in overall complication rates (33.3% [4/12] vs. 41.7% [5/12]; = 1.000).
RFA may be a safe and effective alternative to surgery for superficial parotid PA, offering a shorter median procedure time, shorter hospital stay, and lower costs.
回顾性比较超声引导下射频消融术（RFA）与腮腺切除术治疗浅表多形性腺瘤（PA）的安全性和有效性。
2022年3月至2023年10月，88例被诊断为腮腺浅表PA的患者接受了RFA（n = 12；平均年龄47.1岁）或腮腺切除术（n = 76；平均年龄47.8岁）。根据年龄、性别、肿瘤体积、直径、位置和合并症，使用倾向得分将RFA组患者与手术组患者按1:1的比例进行匹配。在手术前以及术后1、3和6个月的随访中评估超声特征、美容评分（0 - 4分）、数字评分量表评分（0 - 10分）和并发症。比较RFA组基线与随访情况以及RFA组与手术组之间的结果。
在RFA组中，观察到肿瘤体积在基线（中位数，2.02 cm³）与1个月随访之间（中位数，1.21 cm³；P = 0.015）、1个月与3个月随访之间（中位数，0.53 cm³；P = 0.002）以及3个月与6个月随访之间（中位数，0.23 cm³；P = 0.003）均有显著减小。1、3和6个月时的体积缩小率分别为39.7%、79.9%和88.0%。与基线相比，3个月和6个月随访时的美容评分显著更低（中位数分别为1和1，而基线时为4；P = 0.04）。在整个随访过程中，数字评分量表评分与基线相比无显著差异。在倾向得分匹配分析中（每组12例患者），与腮腺切除术相比，RFA的中位手术时间更短（61.5对253.3分钟；P < 0.001），住院时间更短（0对4天；P < 0.001），成本更低（1859.9对3512.4美元；P < 0.001），总体并发症发生率无显著差异（33.3% [4/12]对41.7% [5/12]；P = 1.000）。
对于腮腺浅表PA，RFA可能是一种安全有效的手术替代方法，具有更短的中位手术时间、更短的住院时间和更低的成本。
