Academic radiology · 2025
Comparative Long-term Outcomes of RFA vs. MWA for T1N0M0 Papillary Thyroid Carcinoma in the Danger Triangle: A Dual-Center Retrospective Study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Zhang Dan-Ling, Yu Ming-An, Chen Sheng, Yang Jian-Chuan, Qiu Yuhan, Zhao Zhenlong, Tang LingPeng, Hu Ting, Wu Song-Song
Аннотация
OBJECTIVE: To compare long-term efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) and microwave ablation (MWA) in patients with papillary thyroid carcinoma (PTC) in the thyroid danger triangle.
METHODS: This dual-center retrospective study included 103 patients (age 43.06±11.64; 87 females) with solitary T1N0M0 PTC in the thyroid danger triangle from September 2016 to April 2020, of whom 62 underwent RFA and 41 underwent MWA. Outcomes included disease progression, recurrence-free survival (RFS), volume reduction rate (VRR), and complications, with subgroup analyses for T1a and T1b tumors.
RESULTS: All patients achieved 100% tumor ablation, with 93.2% complete disappearance. Nodule disappearance rates were similar between groups (92.7% vs 95.1%). In the first 6 months, the MWA group had larger nodule diameters and volumes, and a lower VRR (P<0.05), with no differences after 6 months. At follow-up of 71.97±9.72 months, there were no significant differences in disease progression (9.75% vs 4.84%, P=0.332), lymph node metastasis (0% vs 1.6%, P=0.414), Recurrent tumors (7.32% vs 3.23%, P=0.166), Persistent tumors (2.44% vs 0%, P=0.314) or Disease-free survival (90.2% vs 95.1%, P=0.572). There were also no significant differences in disease progression for T1a and T1b tumors. MWA had higher rates of minor complications and transient recurrent laryngeal nerve injury, but no significant difference in recovery time.
CONCLUSION: In long-term follow-up, both RFA and MWA provide high tumor ablation rates and similar disease control for PTC in the thyroid danger triangle, but MWA has a higher complication rate.
METHODS: This dual-center retrospective study included 103 patients (age 43.06±11.64; 87 females) with solitary T1N0M0 PTC in the thyroid danger triangle from September 2016 to April 2020, of whom 62 underwent RFA and 41 underwent MWA. Outcomes included disease progression, recurrence-free survival (RFS), volume reduction rate (VRR), and complications, with subgroup analyses for T1a and T1b tumors.
RESULTS: All patients achieved 100% tumor ablation, with 93.2% complete disappearance. Nodule disappearance rates were similar between groups (92.7% vs 95.1%). In the first 6 months, the MWA group had larger nodule diameters and volumes, and a lower VRR (P<0.05), with no differences after 6 months. At follow-up of 71.97±9.72 months, there were no significant differences in disease progression (9.75% vs 4.84%, P=0.332), lymph node metastasis (0% vs 1.6%, P=0.414), Recurrent tumors (7.32% vs 3.23%, P=0.166), Persistent tumors (2.44% vs 0%, P=0.314) or Disease-free survival (90.2% vs 95.1%, P=0.572). There were also no significant differences in disease progression for T1a and T1b tumors. MWA had higher rates of minor complications and transient recurrent laryngeal nerve injury, but no significant difference in recovery time.
CONCLUSION: In long-term follow-up, both RFA and MWA provide high tumor ablation rates and similar disease control for PTC in the thyroid danger triangle, but MWA has a higher complication rate.