Efficacy and safety of ultrasound-guided thermal ablation for T1N0M0 papillary thyroid carcinoma in adolescent patients.

Abstract

Objective: To evaluate the efficacy and safety of ultrasound-guided thermal ablation (TA)for the treatment of T1N0M0 papillary thyroid carcinoma (PTC) in adolescent patients.

Methods: This retrospective study enrolled adolescent patients with solitary T1N0M0 PTC who underwent TA between January 2015 and January 2025. Patients were stratified into T1a and T1b subgroups based on maximum tumor diameter. The primary outcomes were tumor progression rate and progression-free survival (PFS); secondary outcomes included ablation zone volume dynamics, volume reduction rate, complications, thyroid function, and patient-reported satisfaction.

Results: A total of 82 patients were included (56 in T1a group, 26 in T1b group), with a technical success rate of 100%. The overall median follow-up duration was 36 months (interquartile range [IQR]: 24-60 months). Ablation zone volumes progressively decreased and eventually vanished in all cases. The median time to complete disappearance of the ablation zone was significantly longer in the T1b group than in the T1a group (18 months vs. 12 months, p = 0.014). The overall tumor progression rate was 2.4% (2/82), with no significant difference between subgroups (p = 0.579). Progression-free survival (PFS) rates were comparable between T1a and T1b groups (96.5% vs. 94.0%, p = 0.550). No major complications occurred.

Conclusion: Ultrasound-guided TA is a safe and effective treatment modality for both T1a and T1b subgroups of adolescent patients with solitary T1N0M0 PTC.