Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2026
Thermal Ablation Versus Thyroid Lobectomy for Subcapsular Papillary Thyroid Microcarcinoma: A Multicenter Retrospective Study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Jing Haoyu, Xu Ruifang, Yan Lin, Zhang Mingbo, Wang Hui, Liu Yujiang, Luo Yukun
Аннотация
OBJECTIVES: To compare the efficacy of thermal ablation (TA) with thyroid lobectomy (TL) for clinical node-negative subcapsular papillary thyroid microcarcinoma (PTMC) and to assess the impact of occult lymph node metastasis (LNM) or pathologic local invasion on clinical outcomes.
METHODS: This retrospective study was conducted at 3 referral centers. It included patients with unifocal clinical node-negative subcapsular PTMC who underwent TA (n = 536) or TL (n = 740) from June 2014 to December 2020. The TL group was divided into occult LNM-positive, occult LNM-negative, pathologic local invasion-positive, and pathologic local invasion-negative subgroups based on pathologic findings. Propensity score matching and inverse probability of treatment weighting were used to control for potential confounders. Primary outcomes were disease progression and progression-free survival (PFS). Secondary outcomes included complications and treatment parameters.
RESULTS: The median follow-up duration of the primary cohort was 60.1 (42.0) months. After propensity score matching (519 patients per group), no significant differences were observed in disease progression rates (4.0% vs 2.7%) or 5-year PFS rates (95.8% vs 97.2%) between the TA and TL groups (P > .05). After inverse probability of treatment weighting, the TA group exhibited no significant difference in PFS rates compared to the occult LNM-positive (P = .97) or the pathologic local invasion-positive (P = .66) subgroups. Additionally, TA was associated with lower complication rates compared with TL (0.4% vs 2.1%, P = .01) CONCLUSIONS: In eligible patients with subcapsular PTMC, TA and TL exhibit comparable 5-year disease progression rates and PFS rates. TA may be an alternative option for eligible patients with subcapsular PTMC who are ineligible for or refuse lobectomy.
METHODS: This retrospective study was conducted at 3 referral centers. It included patients with unifocal clinical node-negative subcapsular PTMC who underwent TA (n = 536) or TL (n = 740) from June 2014 to December 2020. The TL group was divided into occult LNM-positive, occult LNM-negative, pathologic local invasion-positive, and pathologic local invasion-negative subgroups based on pathologic findings. Propensity score matching and inverse probability of treatment weighting were used to control for potential confounders. Primary outcomes were disease progression and progression-free survival (PFS). Secondary outcomes included complications and treatment parameters.
RESULTS: The median follow-up duration of the primary cohort was 60.1 (42.0) months. After propensity score matching (519 patients per group), no significant differences were observed in disease progression rates (4.0% vs 2.7%) or 5-year PFS rates (95.8% vs 97.2%) between the TA and TL groups (P > .05). After inverse probability of treatment weighting, the TA group exhibited no significant difference in PFS rates compared to the occult LNM-positive (P = .97) or the pathologic local invasion-positive (P = .66) subgroups. Additionally, TA was associated with lower complication rates compared with TL (0.4% vs 2.1%, P = .01) CONCLUSIONS: In eligible patients with subcapsular PTMC, TA and TL exhibit comparable 5-year disease progression rates and PFS rates. TA may be an alternative option for eligible patients with subcapsular PTMC who are ineligible for or refuse lobectomy.