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Radiofrequency ablation for capsular-located versus noncapsular-located papillary thyroid microcarcinoma: a propensity score matching study of 1095 patients

  • Interventional
  • Published:
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Abstract

Objectives

To assess the safety and efficacy of radiofrequency ablation (RFA) for capsular-located papillary thyroid microcarcinoma (PTMC) in a large cohort and to compare its outcomes with those of noncapsular-located PTMC.

Methods

We retrospectively reviewed patients who underwent RFA for solitary capsular-located and noncapsular-located low-risk PTMC (n = 1095) from June 2014 to October 2020. To balance confounding variables between capsular and noncapsular groups, we employed the 1:1 propensity score matching approach. We evaluated and compared tumor changes, disease progression, and complications in both groups. Furthermore, we analyzed the association between capsular location and disease progression using multivariable Cox regression.

Results

During a mean follow-up time of 29.86 ± 16.14 months and 29.73 ± 15.69 months, no substantial difference was observed between capsular and noncapsular groups in the latest volume (0.83 ± 3.66 mm3 vs. 0.85 ± 3.67 mm3, p = 0.44) and volume reduction ratio (99.29 ± 4.04% vs. 99.43 ± 3.03%, p = 0.43), and cumulative disappearance rate (87.87% vs. 86.07%, p = 0.31). In addition, no significant differences were observed in complication incidence (1.35% vs. 1.12%, p = 0.76) and progression-free survival (p = 0.53). Based on adjusted multivariate Cox proportional hazard analysis, the association between capsular location and disease progression was nonsignificant (all p > 0.05).

Conclusion

This study demonstrates that the short-term outcomes of RFA for capsular-located PTMCs are comparable to those of noncapsular-located PTMCs. These findings indicate that RFA may be a viable and effective alternative for eligible patients with solitary capsular-located PTMC.

Clinical relevance statement

Radiofrequency ablation may serve as a safe and effective alternative treatment method for eligible patients with capsular-located and noncapsular-located papillary thyroid microcarcinoma.

Key Points

• The safety and efficacy of radiofrequency ablation for capsular-located and noncapsular-located papillary thyroid microcarcinomas were comparable.

• Disease progression did not differ significantly between capsular-located and noncapsular-located papillary thyroid microcarcinomas.

• The incidence of complications for capsular-located papillary thyroid microcarcinoma was low.

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Abbreviations

CEUS:

Contrast-enhanced ultrasound

ETE:

Extrathyroidal extension

LNM:

Lymph node metastasis

PSM:

Propensity score matching

PTC:

Papillary thyroid carcinoma

PTMC:

Papillary thyroid microcarcinoma

RFA:

Radiofrequency ablation

SMD:

Standardized mean difference

TA:

Thermal ablation

US:

Ultrasound

VRR:

Volume reduction rate

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Acknowledgements

We would like to thank TopEdit (www.topeditsci.com) for its linguistic assistance during the preparation of this manuscript.

Funding

This study has received funding by Beijing Municipal Science & Technology Commission (No. Z221100003522001).

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Authors and Affiliations

  1. Chinese PLA Medical School, Beijing, China

    Haoyu Jing & Zhen Yang

  2. Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, Beijing, China

    Haoyu Jing, Lin Yan, Jing Xiao, Xinyang Li, Bo Jiang, Zhen Yang, Mingbo Zhang & Yukun Luo

Authors
  1. Haoyu Jing
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  2. Lin Yan
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  3. Jing Xiao
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  7. Mingbo Zhang
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  8. Yukun Luo
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Corresponding authors

Correspondence to Mingbo Zhang or Yukun Luo.

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Guarantor

The scientific guarantor of this publication is Yukun Luo.

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 (for ablation treatment) was obtained from all subjects (patients) in this study; written informed consent for study inclusion was waived due to the retrospective nature.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

The prior study “Long-term outcomes of radiofrequency ablation for unifocal low-risk papillary thyroid microcarcinoma: a large cohort study of 414 patients” (https://doi.org/10.1007/s00330-020-07128-6) evaluated the outcomes of radiofrequency ablation for papillary thyroid microcarcinoma. The current study expands on these findings by increasing the sample size, updating the follow-up time, and including new analyses of both capsular-located and noncapsular-located PTMC.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Jing, H., Yan, L., Xiao, J. et al. Radiofrequency ablation for capsular-located versus noncapsular-located papillary thyroid microcarcinoma: a propensity score matching study of 1095 patients. Eur Radiol (2024). https://doi.org/10.1007/s00330-023-10490-w

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  • DOI: https://doi.org/10.1007/s00330-023-10490-w

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