International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2026
Retrospective multicenter study of thermal ablation outcomes in subcapsular versus intraparenchymal papillary thyroid microcarcinoma.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Jing Haoyu, Chen Qiyang, Zhang Mingbo, Wang Zixin, Xu Ruifang, Wang Hui, Luo Yukun, Liu Yujiang
Аннотация
OBJECTIVE: To evaluate the clinical outcomes of thermal ablation (TA) for subcapsular papillary thyroid microcarcinoma (PTMC) and compared them with those of intraparenchymal PTMC.
METHODS: Patients with unifocal, clinical node-negative PTMC who underwent TA at three institutions between July 2015 and December 2021 were enrolled. Patients were divided into the subcapsular group (PTMC ≤ 2 mm from the capsule) and the intraparenchymal group (PTMC > 2 mm from the capsule). Propensity score matching (PSM) was used to balance between-group confounders. Primary outcomes were disease progression and disease-free survival (DFS); secondary outcomes included post-ablation lesion volume, volume reduction rate (VRR), cumulative tumor disappearance rate, and complications.
RESULTS: A total of 209 and 288 patients were included in the subcapsular and intraparenchymal groups, respectively. During a mean follow-up of 48.4 months, the overall disease progression was 3.4%. Multivariate Cox regression analysis showed no association between subcapsular location and disease progression after adjusting for tumor volume, thyroid-stimulating hormone level, and ablation modality (HR = 1.3 [0.5, 3.5], p = 0.59). After 1:1 PSM, no significant differences between the subcapsular and intraparenchymal groups were observed in primary outcomes (disease progression: 4.3% vs. 3.8%; 5-year DFS rate: 93.2% vs. 93.9%, p = 0.82) or secondary outcomes (complication rate: 1.6% vs. 1.1%; latest volume: 0 mm³ vs. 0 mm³; latest VRR: 99.8% vs. 99.9%; cumulative tumor disappearance rate: 98.9% vs. 99.5%) (all p > 0.05).
CONCLUSION: For eligible subcapsular PTMC patients, TA achieves 4-year clinical outcomes comparable to those of intraparenchymal PTMC cases, warranting further prospective investigations.
METHODS: Patients with unifocal, clinical node-negative PTMC who underwent TA at three institutions between July 2015 and December 2021 were enrolled. Patients were divided into the subcapsular group (PTMC ≤ 2 mm from the capsule) and the intraparenchymal group (PTMC > 2 mm from the capsule). Propensity score matching (PSM) was used to balance between-group confounders. Primary outcomes were disease progression and disease-free survival (DFS); secondary outcomes included post-ablation lesion volume, volume reduction rate (VRR), cumulative tumor disappearance rate, and complications.
RESULTS: A total of 209 and 288 patients were included in the subcapsular and intraparenchymal groups, respectively. During a mean follow-up of 48.4 months, the overall disease progression was 3.4%. Multivariate Cox regression analysis showed no association between subcapsular location and disease progression after adjusting for tumor volume, thyroid-stimulating hormone level, and ablation modality (HR = 1.3 [0.5, 3.5], p = 0.59). After 1:1 PSM, no significant differences between the subcapsular and intraparenchymal groups were observed in primary outcomes (disease progression: 4.3% vs. 3.8%; 5-year DFS rate: 93.2% vs. 93.9%, p = 0.82) or secondary outcomes (complication rate: 1.6% vs. 1.1%; latest volume: 0 mm³ vs. 0 mm³; latest VRR: 99.8% vs. 99.9%; cumulative tumor disappearance rate: 98.9% vs. 99.5%) (all p > 0.05).
CONCLUSION: For eligible subcapsular PTMC patients, TA achieves 4-year clinical outcomes comparable to those of intraparenchymal PTMC cases, warranting further prospective investigations.