Ultrasonography-guided radiofrequency ablation vs. surgery for the treatment of solitary T1bN0M0 papillary thyroid carcinoma: A comparative study
Ultrasonography-guided radiofrequency ablation vs. surgery for the treatment of solitary T1bN0M0 papillary thyroid carcinoma: A comparative study
复制标题
超声引导下射频消融与手术治疗孤立性 T1bN0M0 甲状腺乳头状癌的比较研究
DOI：
10.1111/cen.14361
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发表时间：
2020-12-09
影响因子：
3.2
通讯作者：
Tang, Jie
中科院分区：
文献类型：
--
作者：
Xiao, Jing;Zhang, Yan;Tang, Jie
目的超声引导下射频消融治疗低危型甲状腺小乳头状癌（PTC）取得了良好的疗效。然而，很少有研究已经进行了RFA的管理T1 bN 0 M0 PTC的应用。因此，本研究旨在比较RFA与手术治疗临床孤立性T1 bN 0 M0 PTC的中期结果。设计这是一项回顾性研究。2014年4月至2019年5月期间，182例孤立性T1 bN 0 M0 PTC患者接受了RFA或手术治疗（n = 91/组）。测量主要终点是局部肿瘤进展和并发症发生率。局部肿瘤进展被定义为：（a）新的或持续性PTC证实的芯针活检;（B）颈部淋巴结转移（LNM）证实的芯针活检或手术;（c）消融区增加在RFA group.Results组中，局部肿瘤进展被认为是在4例（4.4%，3个持续性PTC和1个LNM）。在手术组中，2例患者（2.2%）发生LNM;未确认新发或持续性PTC。在局部肿瘤进展方面，两组之间无显著差异。永久性甲状旁腺功能减退观察4例（4.4%）的手术组，而没有重大或轻微的并发症，观察在RFA group.Conclusions超声引导下RFA治疗孤立性T1 bN 0 M0 PTC是可行的，安全的，所以它可以被认为是一种替代手术的选择患者，特别是那些不符合条件或拒绝手术。
Objective Ultrasonography-guided radiofrequency ablation (RFA) has been used to treat low-risk small papillary thyroid carcinoma (PTC) and yielded promising results. However, little research has been conducted on the application of RFA for the management of T1bN0M0 PTC. Therefore, this study was to compare the midterm outcome of RFA with that of surgery for the treatment of clinical solitary T1bN0M0 PTC.Design This is a retrospective study.Patients In total, 182 patients with solitary T1bN0M0 PTC between April 2014 and May 2019 were treated with RFA or surgery (n = 91/group).Measurements The primary end points were local tumour progression and complication rates. Local tumour progression were defined as: (a) new or persistent PTC confirmed by core needle biopsy; (b) cervical lymph node metastasis (LNM) confirmed by core needle biopsy or surgery; (c) ablation zone increased in the RFA group.Results In the RFA group, local tumour progression was seen in four patients (4.4%, three persistent PTC and one LNM). In the surgery group, two patients (2.2%) developed LNM; no new or persistent PTC was confirmed. There was no significant difference between the two groups in local tumour progression. Permanent hypoparathyroidism was observed in four patients (4.4%) in the surgery group, while no major or minor complications were observed in the RFA group.Conclusions Ultrasonography-guided RFA is feasible and safe for treating solitary T1bN0M0 PTC, so it may be considered an alternative to surgery in select patients, especially those who are ineligible for or refusal of surgery.