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Comparison of ultrasound-guided radiofrequency ablation versus thyroid lobectomy for T1bN0M0 papillary thyroid carcinoma

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Abstracts

Objective

To investigate and compare the clinical outcomes between radiofrequency ablation (RFA) and thyroid lobectomy (TL) for T1bN0M0 papillary thyroid carcinoma (PTC).

Methods

This retrospective study evaluated 283 patients with solitary T1bN0M0 PTC treated with RFA (RFA group, 91 patients) or TL (TL group, 192 patients) from May 2014 to November 2018. The patients were regularly followed up after treatment. Local tumor progression, lymph node metastasis (LNM), recurrent tumor, persistent tumor, recurrence-free survival (RFS), treatment variables (hospitalization, procedure time, estimated blood loss, and cost), complication, and delayed surgery were compared.

Results

During the follow-up (median [interquartile ranges], 50.4 [18.0] months), no significant differences were found in the local tumor progression (4.4% vs 3.6%, p = 1.000), LNM (1.1% vs 2.1%, p = 0.917), recurrent tumor (2.2% vs 1.6%, p = 1.000), persistent tumor (1.1% vs 0%, p = 0.146), and RFS rate (95.6% vs 96.4%, p = 0.816) in the RFA and TL groups. Distant metastasis was not detected. Patients in the RFA group had a shorter hospitalization (0 vs 7.0 [3.0] days, p < 0.001), shorter procedure time (5.6 [2.9] vs 90.0 [38.5] min, p < 0.001), lower estimated blood loss (0 vs 20 [20] mL, p < 0.001), lower cost ($1972.5 [0.1] vs $2362.4 [1009.3], p < 0.001), and lower complication rate (0 vs 12/192 [6.3%], p = 0.015) than those in the TL group. No patients in the RFA group underwent delayed surgery.

Conclusions

This study revealed comparable 4-year clinical outcomes between RFA and TL for T1bN0M0 PTC in terms of local tumor progression and RFS. As a minimally invasive modality, RFA may be a promising feasible alternative to surgery for the treatment of T1bN0M0 PTC in selected patients after strict evaluation.

Key Points

• No significant difference in local tumor progression and RFS was found between RFA and TL for T1bN0M0 PTC during a median follow-up period of 50.4 months.

• Compared with TL, RFA led to a shorter hospitalization, lower estimated blood loss, lower cost, and lower complication rate.

• RFA may be a promising feasible alternative to surgery for the treatment of T1bN0M0 PTC in selected patients after strict evaluation.

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Abbreviations

AS:

Active surveillance

CECT:

Contrast-enhanced computed tomography

CEUS:

Contrast-enhanced ultrasound

CNB:

Core-needle biopsy

CND:

Central neck dissection

ETE:

Extrathyroidal extension

FNA:

Fine-needle aspiration

LNM:

Lymph node metastasis

PTC:

Papillary thyroid carcinoma

RFA:

Radiofrequency ablation

RFS:

Recurrence-free survival

RLN:

Recurrent laryngeal nerve

TL:

Thyroid lobectomy

US:

Ultrasound

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Authors and Affiliations

  1. Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Lin Yan, Xinyang Li, Yingying Li, Jing Xiao, Mingbo Zhang & Yukun Luo

  2. School of Medicine, Nankai University, No. 94 Weijin Road, Nankai District, Tianjin, 300071, China

    Xinyang Li

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  1. Lin Yan
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  2. Xinyang Li
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  5. Mingbo Zhang
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  6. Yukun Luo
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Correspondence to Yukun Luo.

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The scientific guarantor of this publication is Yukun Luo.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional review board approval was obtained.

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• retrospective

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• performed at one institution

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Yan, L., Li, X., Li, Y. et al. Comparison of ultrasound-guided radiofrequency ablation versus thyroid lobectomy for T1bN0M0 papillary thyroid carcinoma. Eur Radiol 33, 730–740 (2023). https://doi.org/10.1007/s00330-022-08963-5

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  • DOI: https://doi.org/10.1007/s00330-022-08963-5

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