Early Outcomes of Thermal Ablation for Low-Risk Papillary Thyroid Cancer: A Multicenter Study from Latin American Interventional Thyroidology Association (LAITA).

IF 6.6 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Thyroid Pub Date : 2026-10-01 Epub Date: 2026-08-06 DOI:10.1177/10507256261475837

Juan Pablo Dueñas, Nathalia Buitrago-Gómez, Antonio Rahal, Jose Higinio Steck, Gustavo Philippi de Los Santos, Cristhian García, Emerson Favero, Rafael De Cicco, Leonardo G Rangel, Richard Godoy, Eleonora Horvath, Juan Pablo Niedmann Espinosa, Ana Voogd, Lorena Savluk, Erick Gonzales, Antonio Augusto Tupinambá Bertelli, Camilo González-Velazquez, Leonardo de Moura Volpi, Erivelto Martinho Volpi

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引用次数: 0

Abstract

Background: Thermal ablation has emerged as a minimally invasive alternative for low-risk papillary thyroid cancer (PTC). However, data from Latin America remain scarce. This multicenter study evaluated the early efficacy and safety of thermal ablation for low-risk PTC across multiple Latin American centers.

Methods: Retrospective cohort study including 251 patients with 252 tumors (T1N0M0 PTC, ≤2 cm) treated with ultrasound-guided radiofrequency ablation (RFA) at 12 centers across 6 Latin American countries from January 2019 to June 2025. Primary outcomes were complete tumor disappearance, disease progression, and complications.

Results: Median age was 45.5 years (interquartile range [IQR]: 36.5-56), with 74.2% female patients. Median tumor size was 6.7 mm (IQR: 5-8); 92.1% were T1a (≤10 mm). After a median follow-up of 18 months (IQR 12-24, range 12-72), complete tumor disappearance was achieved in 89.7% overall (226/252), reaching 97.0% in tumors with ≥18 months and 100% with ≥36 months of follow-up. Tumor persistence was observed in 10.3% (26/252) at last follow-up, with no lymph node or distant metastases. The overall complication rate was 2.4% (6/252), all consisting of transient dysphonia. On multivariable analysis, tumor size >10 mm was independently associated with a lower likelihood of complete tumor disappearance (adjusted odds ratios [OR] 0.23 [CI: 0.07-0.78]), whereas follow-up >12 months was associated with a higher likelihood (adjusted OR: 11.33 [CI: 3.61-35.6]). A supplementary post hoc analysis suggested a possible association between higher general operator volume (≥250 RFA procedures) and complete disappearance.

Conclusions: RFA demonstrates excellent efficacy and acceptable safety for T1a low-risk PTC in Latin American patients, with outcomes comparable with other series, supporting it as a viable alternative to surgery or active surveillance in selected patients. Efficacy for T1b tumors was lower and based on a small number of cases; ablation of T1b disease should therefore be regarded as requiring further investigation, ideally within the framework of a clinical trial.

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热消融治疗低风险乳头状甲状腺癌的早期结果：拉丁美洲介入甲状腺学协会（LAITA）的一项多中心研究。

背景：热消融已成为低风险甲状腺乳头状癌（PTC）的一种微创治疗方法。然而，来自拉丁美洲的数据仍然很少。这项多中心研究评估了拉丁美洲多个中心热消融治疗低风险PTC的早期疗效和安全性。方法：回顾性队列研究，包括2019年1月至2025年6月在6个拉丁美洲国家的12个中心接受超声引导射频消融（RFA）治疗的251例患者，共252例肿瘤（T1N0M0 PTC,≤2 cm）。主要结局是肿瘤完全消失、疾病进展和并发症。结果：中位年龄为45.5岁（四分位数间距[IQR]: 36.5-56），女性占74.2%。中位肿瘤大小6.7 mm (IQR: 5-8)；92.1%为T1a（≤10 mm）。中位随访18个月（IQR 12-24，范围12-72），89.7%的患者（226/252）肿瘤完全消失，≥18个月的患者达到97.0%，≥36个月的患者达到100%。在最后一次随访中，肿瘤持续存在10.3%(26/252)，无淋巴结或远处转移。总并发症发生率为2.4%(6/252)，均为一过性语音障碍。在多变量分析中，肿瘤大小>0 mm与肿瘤完全消失的可能性较低独立相关（调整比值比[OR] 0.23 [CI: 0.07-0.78]），而随访>12个月与肿瘤完全消失的可能性较高相关（调整比值比：11.33 [CI: 3.61-35.6]）。一项补充的事后分析表明，较高的一般手术量（≥250次RFA手术）与完全消失之间可能存在关联。结论：RFA在拉丁美洲T1a低风险PTC患者中表现出出色的疗效和可接受的安全性，其结果与其他系列相当，支持其作为选择性患者手术或主动监测的可行替代方案。对T1b肿瘤的疗效较低，且基于少量病例；因此，T1b疾病的消融应被视为需要进一步研究，最好是在临床试验的框架内。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thyroid 医学-内分泌学与代谢

CiteScore

12.30

自引率

6.10%

发文量

195

审稿时长

6 months

期刊介绍： This authoritative journal program, including the monthly flagship journal Thyroid, Clinical Thyroidology® (monthly), and VideoEndocrinology™ (quarterly), delivers in-depth coverage on topics from clinical application and primary care, to the latest advances in diagnostic imaging and surgical techniques and technologies, designed to optimize patient care and outcomes. Thyroid is the leading, peer-reviewed resource for original articles, patient-focused reports, and translational research on thyroid cancer and all thyroid related diseases. The Journal delivers the latest findings on topics from primary care to clinical application, and is the exclusive source for the authoritative and updated American Thyroid Association (ATA) Guidelines for Managing Thyroid Disease.