Clinical outcomes of radiofrequency ablation for solitary T1aN0M0 versus T1bN0M0 papillary thyroid carcinoma: a propensity-matched cohort study

Abstract

Objective

To conduct a cohort study comparing the treatment outcomes of radiofrequency ablation (RFA) therapy for solitary T1aN0M0 (T1a) versus T1bN0M0 (T1b) papillary thyroid carcinoma (PTC).

Methods

This retrospective analysis comprised 310 patients with low-risk PTC undergoing RFA classified into T1a (n = 272) and T1b (n = 38) groups according to the tumor size. A comparative analysis between the two groups was conducted for the volume reduction ratio (VRR), volume, local tumor progression (LTP), and recurrence-free survival (RFS) before and after 1:2 propensity score matching (PSM). Cox analysis was conducted to examine the influence of several variables, including T1b, on recurrence following RFA for PTC.

Results

The total VRR was 99.99 ± 0.11% throughout the median follow-up duration of 26 months, and the overall incidence of LTP was 2.58% (8/310). No irrecoverable complications occurred after RFA. The variations between the T1a and T1b groups following PSM were insignificant in terms of volume (p = 0.574), VRR (p = 0.574), complete disappearance rate (p = 0.210), LTP incidence (p = 1.000), and RFS rate (p = 0.610). The correlation between T1b and LTP continued to be insignificant (p = 0.686). No distant metastasis or delayed surgery occurred.

Conclusions

The presence of T1b did not influence the patients’ prognoses following RFA for T1N0M0 PTC. After appropriate patient selection and adequate preoperative assessment, RFA has the potential to serve as an effective therapy for individuals with T1a and T1b PTC.

Keywords:

• Thyroid
• papillary cancer
• thermal ablation
• radiofrequency
• ultrasonography

Acknowledgments

Not applicable.

Ethics approval and participation consent

This study was approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University (No. PJ-KS-KY-2022-346), which waived the requirement for informed consent.

Informed consent

Informed consent was obtained from all subjects (patients) in this study.

Institutional Review Board approval was obtained.

Authors’ contributions

MT and LW collected and analyzed the data, and wrote the paper. ZG and YZ designed figures. YC treated patients and oversaw the study.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Study subjects or cohorts overlap

Not applicable.

Methodology

Retrospective/observational/performed at one institution.

Guarantor

The scientific guarantor of this publication is Ying Che.

Disclosure statement

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.

Data availability statement

Confirmed.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (82003143) and the Natural Science Foundation of Liaoning Province (2021-BS-211).