Safety and efficacy of thermal ablation for cervical metastatic lymph nodes in papillary thyroid carcinoma: A systematic review and meta-analysis.
Safety and efficacy of thermal ablation for cervical metastatic lymph nodes in papillary thyroid carcinoma: A systematic review and meta-analysis.
复制标题
DOI：
10.3389/fendo.2022.967044
复制
发表时间：
2022
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
--
作者：
评价射频消融（RFA）、微波消融（MWA）和激光消融（LA）治疗甲状腺乳头状癌（PTC）颈部转移淋巴结（CMLN）的安全性和有效性。检索Pubmed、EMBASE、Web of Science和科克伦图书馆数据库中关于热消融（RFA、MWA和LA）治疗PTC CMLN的安全性和有效性的研究，截止日期为2022年3月30日。对334篇潜在论文进行审查，确定了17篇合格论文，包括312例患者。使用固定效应模型或随机效应模型评价消融后减容率（VRR）、完全消失和复发的汇总比例，以及最大直径、体积和血清Tg变化的汇总估计值。计算总体和主要并发症的汇总比例。基于治疗方式的亚组分析。采用Q统计量和不一致性指数I2分析研究间异质性。采用MINORS量表评价研究质量。最终确定了17项合格研究，包括312例患者和559例CMLN。CMLN的VRR、完全消失和复发的合并比例分别为91.28% [95%置信区间（CI）：86.60-95.97%]、67.9% [95%CI：53.1-81.1%]和7.8% [95%CI：3.0-14.1%]。最大直径、体积和血清Tg变化的合并估计值分别为8.12 mm [95%CI：6.78-9.46 mm]、338.75 mm 3 [95%CI：206.85 - 470.65 mm 3]和5.96 ng/ml [95%CI：3.68-8.24 ng/ml]。总体和重大并发症的汇总比例分别为2.9% [95%CI：0.3-7.1%]和0.3% [95%CI：0-1.9%]。观察到完全消失的显著研究间异质性（P<0.01，I2 =88.6%），VRR（P<0.001，I2 =99.9%），复发（P=0.02，I2 =47.76%），总体并发症最大直径（P<0.001，I2 =82.6%）、体积（P <0.001，I2 =97.0%）和血清Tg（P <0.001，I2 =93.7%）的变化。亚组分析显示治疗方式之间的VRR异质性（I2范围：84.4-100%）。MWA的VRR最高（97.97%），RFA次之（95.57%），LA最低（84.46%）（P < 0.001）。所有热消融治疗PTC CMLN均安全有效。然而，每个处理的VRR有显着的异质性。与RFA和MWA相比，LA减少PTC CMLN体积的效果较差。
To evaluate the safety and efficacy of radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA) for the treatment of cervical metastatic lymph nodes (CMLNs) of papillary thyroid carcinoma (PTC). The Pubmed, EMBASE, Web of Science, and Cochrane Library databases were searched for studies on the safety and efficacy of thermal ablations (RFA, MWA, and LA) for the treatment of CMLNs of PTC until March 30, 2022. A review of 334 potential papers identified 17 eligible papers including 312 patients. Fixed-effects model or random-effects model was used to evaluate the pooled proportions of volume reduction rate (VRR), complete disappearance, and recurrence, and pooled estimates of changes in the largest diameter, volume, and serum Tg after ablation. The pooled proportions of overall and major complications were calculated. Subgroup analysis based on treatment modalities. The heterogeneity among studies was analyzed by using Q statistics and inconsistency index I2 . MINORS scale was used to evaluate the quality of the studies. 17 eligible studies were finally identified, including 312 patients and 559 CMLNs. The pooled proportions of VRR, complete disappearance and recurrence of CMLNs were 91.28% [95% confidence interval (CI): 86.60-95.97%], 67.9% [95% CI: 53.1-81.1%] and 7.8% [95%CI: 3.0-14.1%], respectively. The pooled estimates of changes in the largest diameter, volume and serum Tg were 8.12 mm [95%CI: 6.78-9.46 mm], 338.75 mm3 [95%CI: 206.85 -470.65 mm3] and 5.96 ng/ml [95%CI: 3.68-8.24 ng/ml], respectively. The pooled proportions of overall and major complications were 2.9% [95%CI: 0.3-7.1%] and 0.3% [95%CI: 0-1.9%], respectively. Significant between-study heterogeneity was observed for complete disappearance (P<0.01, I2 =88.6%), VRR (P<0.001, I2 =99.9%), recurrence (P=0.02, I2 =47.76%), overall complications (P<0.02, I2 =44.8%), and changes in the largest diameter (P < 0.001, I2 =82.6%), volume (P<0.001, I2 =97.0%), and serum Tg (P < 0.001, I2 =93.7%). Subgroup analysis showed heterogeneity of the VRR among the treatment modality (I2 range: 84.4-100%). The VRR of MWA was the highest (97.97%), followed by RFA (95.57%) and LA (84.46%) (P < 0.001). All thermal ablations were safe and effective for the treatment of CMLNs of PTC. However, each treatment had significant heterogeneity in VRR. Compared with RFA and MWA, LA was less effective in reducing the volume of CMLNs of PTC.
登录
查看更多内容
影响因子：
3.9
作者：
Offi C;Misso C;Antonelli G;Esposito MG;Brancaccio U;Spiezia S
通讯作者：
Spiezia S
影响因子：
5.8
作者：
Mauri, G.;Cova, L.;Solbiati, L.
通讯作者：
Solbiati, L.
影响因子：
19.7
作者：
Kim, Ji-hoon;Yoo, Won Sang;Cho, Bo Youn
通讯作者：
Cho, Bo Youn
影响因子：
2.8
作者：
Nguyen VB;Nguyen TX;Nguyen VVH;Nguyen HT;Nguyen DT;Le CV
通讯作者：
Le CV
影响因子：
3.1
作者：
Cao, Xiao-Jing;Wei, Ying;Yu, Ming-An
通讯作者：
Yu, Ming-An