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Long-term efficacy of microwave ablation for multifocal papillary thyroid microcarcinoma: a 5-year follow-up study

  • Ultrasound
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Microwave ablation (MWA) has achieved excellent long-term efficacy in treating unifocal papillary thyroid microcarcinoma (UPTMC). The therapeutic effect of this treatment on multifocal papillary thyroid microcarcinoma (MPTMC) is unknown. Therefore, we evaluated the long-term efficacy of MWA for low-risk MPTMC and to provide evidence-based medicine for the revision of clinical guidelines.

Methods

This study included 66 MPTMC patients with a total of 158 lesions, all of whom received MWA. We collected and retrospectively analyzed the patients’ follow-up data before MWA, at 1, 3, 6, and 12 months posttreatment and every 6 months thereafter until 5 years posttreatment. We evaluated the MWA complication rate, technical success rate (TSR), lesion volume reduction rate (VRR), and complete disappearance rate (CDR) during follow-up and in those patients with tumor progression and delayed surgery.

Results

After 60 months of follow-up, all 158 lesions disappeared in 66 patients, and the volume was reduced from 43.82 mm3 to 0.00 mm3. The TSR and VRR were both 100%. The CDRs at 1 year, 2 years, and 3 years were 57.59%, 93.67%, and 100%, respectively. The complication rate was 3.03% (2/66), and the incidence of tumor progression was 3.03% (2/66), including one new intrathyroidal lesion and one cervical lymph node metastasis (LNM). These lesions were retreated with MWA, and the lesions disappeared during the follow-up period.

Conclusions

Ultrasound-guided MWA for low-risk MPTMC is safe and effective and may serve as an alternative option for patients who refuse surgery or active surveillance (AS).

Clinical relevance statement

This study concludes that ultrasound-guided microwave ablation for low-risk multifocal papillary thyroid microcarcinoma is safe and effective and may serve as an alternative option for patients who refuse surgery or active surveillance.

Key Points

• Ultrasound-guided microwave ablation for low-risk multifocal papillary thyroid microcarcinoma is safe and effective.

• During 5 years of follow-up, multifocal papillary thyroid microcarcinoma patients treated with microwave ablation had a favorable prognosis.

• To provide evidence-based medicine for the revision of clinical guidelines.

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Abbreviations

AS:

Active surveillance

ATA:

American Thyroid Association

CDFI:

Color Doppler flow imaging

CDR:

Complete disappearance rate

CEUS:

Contrast-enhanced ultrasonography

CNB:

Core needle biopsy

ETE:

Extrathyroidal extension

FNA:

Fine-needle aspiration

IQR:

Interquartile range

LNM:

Lymph node metastasis

MWA:

Microwave ablation

MPTMC:

Multifocal papillary thyroid microcarcinoma

PTMC:

Papillary thyroid microcarcinoma

TSR:

Technical success rate

TSH:

Thyrotropin

UPTMC:

Unifocal papillary thyroid microcarcinoma

V:

Volume

VRR:

Volume reduction rate

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Acknowledgements

This study was supported by Finance Department of Jilin Province (NO.2021SCZ26) and Finance Department of Jilin Province (NO.2020SCZ08).

Funding

This study was funded by Finance Department of Jilin Province (NO. 2021SCZ26) and Finance Department of Jilin Province (NO.2020SCZ08).

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Authors and Affiliations

  1. Department of Ultrasound, China-Japan Union Hospital of Jilin University, No. 126, Xian Tai Street, Changchun, Jilin, 130033, China

    Peng Dong, Deng-Ke Teng, Guo-Qing Sui, Yuan-Qiang Lin, Qiang Luo, Qi-Meihui Wang, He-Qun Li & Hui Wang

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  1. Peng Dong
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  2. Deng-Ke Teng
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Contributions

Peng Dong: literature research, experimental studies/data analysis, statistical analysis and writing original draft

Deng-Ke Teng: study concepts, review and editing

Guo-Qing Sui: clinical studies and literature research

Yuan-Qiang Lin: statistical analysis

Qiang Luo: literature research and statistical analysis

Qi-Meihui Wang: software and article preparation

He-Qun Li: writing review and editing

Hui Wang: guarantor of integrity of the entire study, review and editing, design

Corresponding author

Correspondence to Hui Wang.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Hui Wang.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

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

Ethical approval

This study was approved by the ethics committee of China-Japan Union Hospital of Jilin University.

Study subjects or cohorts overlap

There is no overlap in study subjects or cohorts.

Methodology

  • Retrospective study

  • Diagnostic or prognostic study

  • performed at one institution

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Dong, P., Teng, DK., Sui, GQ. et al. Long-term efficacy of microwave ablation for multifocal papillary thyroid microcarcinoma: a 5-year follow-up study. Eur Radiol 34, 715–723 (2024). https://doi.org/10.1007/s00330-023-10117-0

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  • DOI: https://doi.org/10.1007/s00330-023-10117-0

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