Thermal ablation versus surgical resection for US-detected T2N0M0 papillary thyroid carcinoma.

Background: Thermal ablation (TA) has demonstrated promising efficacy and safety in treating papillary thyroid carcinoma (PTC). However, comparative analyses between TA and surgical resection (SR) for treating T2N0M0 PTC remain scarce.

Purpose: To compare the efficacy and safety of TA and SR in treating preoperatively US-detected T2N0M0 PTC.

Materials and methods: In this retrospective study, 252 patients with preoperative US-detected T2N0M0 PTC treated by TA or SR between July 2016 and May 2024 were included. Comparative study based on propensity score matching (PSM) between the TA and SR groups was conducted.

Results: After PSM, 63 patients (median age: 40 years [IQR 34-53], 49 females) in the TA group and 126 patients (median age: 41 years [IQR 32-52.5], 102 females) in the SR group were followed for a median of 35 months (IQR 18-62) and 46 months (IQR 29-60), respectively (P = 0.093). There was no evidence of differences in disease progression between the TA and SR groups (11.1% vs. 7.9%; P = 0.59) or progression-free survival rates between the TA and SR groups (86.4% vs. 89.6%, P = 0.37). Compared with SR, TA resulted in less blood loss, a shorter incision length, and shorter procedure and hospitalization times (all, P < 0.001). Although there was a relatively higher incidence of hoarseness in the TA group, no significant difference was observed between the TA and SR groups (12.7% vs. 8.7%, P = 0.444) or between the TA and lobectomy (i.e. hemithyroidectomy and subtotal thyroidectomy) groups (12.7% vs. 5.9%, P = 0.340).

Conclusions: There were no significant differences in disease progression and hoarseness between TA and SR for US-detected T2N0M0 PTC. TA is an effective and safe treatment option for US-detected T2N0M0 PTC.