Zhao Zhenlong, Fan Boqiang, He Junfeng, Zhou Ying, Wu Songsong, Wang Shurong, Dong Gang, Guo Jianqin, Wei Ying, Wu Jie, Cao Shiliang, Li Yan, Yu Ming'an
Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China.
Department of Oncology, Jiangsu Province Hospital, Nanjing, Jiangsu.
Int J Hyperthermia. 2025 Dec;42(1):2539177. doi: 10.1080/02656736.2025.2539177. Epub 2025 Aug 6.
To compare thermal ablation (TA) and surgical resection (SR) for follicular thyroid neoplasm (FTN) with F-TIRADS score lower than 12 points in terms of overall, 1-, 3-, and 5-year progression-free survival rates and complication rates.
In this retrospective study, 692 patients with FTN treated by TA or SR across 9 centers between January 2014 and June 2023 were included. The primary outcomes were overall and 1-, 3-, and 5-year progression-free survival rates and complication rates.
As a result, 258 patients (median age: 43.5 years, 205 females) in the TA group and 135 patients (median age: 49 years, 101 females) in the SR group were followed for a median of 23 months and 25 months, respectively. TA resulted in shorter incision length, procedure durations and hospitalization (all < 0.001). There was no evidence of differences in overall, 1-, 3-, or 5-year progression-free survival rates (all > 0.05) between TA and SR (5-year: 98.6% vs. 99.4%, = 0.31). Permanent hoarseness (8.1% [15/135], < 0.001), permanent hypoparathyroidism (0.7% [1/135], = 0.74), transient hypoparathyroidism (3.0% [4/135], = 0.02) and the need for lifelong hormone replacement therapy (64.4% [87/135], < 0.001) were encountered only in the SR group.
There was no evidence of difference in progression-free survival rates between TA and SR for FTN with F-TIRADS score lower than 12 points, and TA resulted in fewer complications and no need of hormone replacement therapy. Therefore, TA is a feasible alternative for selected patients with FTN.
比较热消融（TA）与手术切除（SR）治疗F-TIRADS评分低于12分的滤泡性甲状腺肿瘤（FTN）患者的总体、1年、3年和5年无进展生存率及并发症发生率。
本回顾性研究纳入了2014年1月至2023年6月期间9个中心接受TA或SR治疗的692例FTN患者。主要结局指标为总体、1年、3年和5年无进展生存率及并发症发生率。
TA组258例患者（中位年龄：43.5岁，女性205例）和SR组135例患者（中位年龄：49岁，女性101例）分别随访了23个月和25个月。TA组的切口长度、手术时间和住院时间均较短（均P<0.001）。TA与SR在总体、1年、3年或5年无进展生存率方面无差异（均P>0.05）（5年：98.6%对99.4%，P=0.31）。仅SR组出现了永久性声音嘶哑（8.1%[15/135]，P<0.001）、永久性甲状旁腺功能减退（0.7%[1/135]，P=0.74）、暂时性甲状旁腺功能减退（3.0%[4/135]，P=0.02）以及终身激素替代治疗需求（64.4%[87/135]，P<0.001）。
对于F-TIRADS评分低于12分的FTN患者，TA与SR在无进展生存率方面无差异，且TA并发症更少，无需激素替代治疗。因此，TA是部分FTN患者的可行替代方案。
