Thermal Ablation for Low-risk Papillary Thyroid Carcinoma: Comparing Outcomes in T1N0M0 and T2N0M0 PTC.

Abstract

Background: Thermal ablation (TA) has demonstrated promising treatment efficacy and safety in T1N0M0 papillary thyroid carcinoma (PTC). However, the efficacy and safety of TA for T2N0M0 PTC still lack sufficient evidence.

Purpose: To compare the technical effectiveness, disease progression, and complications of TA in the treatment of solitary T1N0M0 versus solitary T2N0M0 PTC.

Materials and methods: In this retrospective study, 1159 patients with PTC treated with TA from January 2015 to June 2024 were included and divided into two groups according to tumor stage. Propensity score matching (PSM) was used to control for confounding factors. Kaplan-Meier curves were used to analyze the disease progression.

Results: After PSM (1:4), 41 patients (median age 35 years [IQR 30-49]; 30 women) were included in the T2 group, and 164 patients (median age 34 years [IQR 29-43]; 108 women) were included in the T1 group. The median follow-up durations were 26 months (IQR 13-49) for the T2 group and 25 months (IQR 12.3-43) for the T1 group. The technical success rates were 100% in the two groups. Statistical analysis showed no significant differences in disease progression between the T1 and T2 groups (0.6% vs. 4.9%, P=0.103), nor in disease progression-free survival rates (98.2% vs. 88.6%, log-rank P=0.052). The incidence of major complications was higher in the T2 group than that in the T1 group (1.8% vs. 17.1%, P=0.001). No permanent hoarseness was observed in the two groups.

Conclusion: TA could be a safe and effective option in the treatment of solitary T2N0M0 PTC. No significant difference was observed in disease progression between T1N0M0 and T2N0M0 PTC.