Clinical outcomes of radiofrequency ablation for solitary T1aN0M0 versus T1bN0M0 papillary thyroid carcinoma: a propensity-matched cohort study
Clinical outcomes of radiofrequency ablation for solitary T1aN0M0 versus T1bN0M0 papillary thyroid carcinoma: a propensity-matched cohort study
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DOI：
10.1080/02656736.2023.2257908
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发表时间：
2023-10
影响因子：
3.1
通讯作者：
Mengying Tong;Linchun Wang;Ziru Gai;Ya-Lin Zhu;Y. Che
中科院分区：
文献类型：
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作者：
Mengying Tong;Linchun Wang;Ziru Gai;Ya-Lin Zhu;Y. Che
目的通过队列研究比较射频消融（RFA）治疗孤立性T1aN0M0 （T1a）与T1bN0M0 （T1b）甲状腺乳头状癌（PTC）的疗效。方法回顾性分析310例经RFA治疗的低危PTC患者，根据肿瘤大小分为T1a组（n = 272）和T1b组（n = 38）。比较分析两组患者1:2倾向评分匹配（PSM）前后的体积缩小率（VRR）、体积、局部肿瘤进展（LTP）、无复发生存率（RFS）。采用Cox分析来检验包括T1b在内的几个变量对RFA后PTC复发的影响。结果中位随访26个月，总VRR为99.99±0.11%，LTP总发生率为2.58%（8/310）。RFA术后未发生不可恢复性并发症。PSM后T1a组和T1b组在体积（p = 0.574）、VRR （p = 0.574）、完全消失率（p = 0.210）、LTP发生率（p = 1.000）和RFS率（p = 0.610）方面差异不显著。T1b与LTP的相关性仍然不显著（p = 0.686）。无远处转移或延迟手术发生。结论T1b的存在不影响T1N0M0 PTC患者RFA后的预后。经过适当的患者选择和充分的术前评估，RFA有可能作为T1a和T1b PTC患者的有效治疗方法。
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.