Microwave ablation has emerged as a promising alternative to surgical resection for the treatment of papillary thyroid carcinoma (PTC), particularly in cases of multifocal disease.
In the study, led by senior author Ming-An Yu, the research challenges conventional treatment paradigms and offers new avenues for less invasive management strategies.
PTC, the most prevalent form of thyroid cancer, often presents with multifocality, complicating treatment decisions.
Surgical resection has been the go-to approach, but it comes with drawbacks such as scarring, lifelong hormone replacement therapy, and potential complications like permanent hoarseness or impaired thyroid function.
Researchers analysed data from 775 patients with ultrasound-detected multifocal Stage I PTC treated across ten centres between May 2015 and December 2021.
Propensity score matching ensured a fair comparison between microwave ablation and surgery groups, with 229 patients undergoing the former and 453 the latter.
Over a median follow-up of 20 to 26 months, microwave ablation demonstrated similar progression-free survival rates to surgery (five-year: 77.2% vs. 83.1%) but with notable advantages.
It was associated with less blood loss, shorter incision length, and shorter procedure and hospitalisation durations.
Complications such as permanent hoarseness (2.2%) and hypoparathyroidism (4.0%) were encountered only in the surgical resection group.
Dr Yu highlighted that microwave ablation does not routinely include preventative ablation of lymph nodes, a common practice in surgical resection.
However, the study’s findings suggest microwave ablation can achieve comparable survival rates without lymph node ablation.
Dr Yu said: ‘This study marks the first multicentre comparative analysis between microwave ablation and surgical resection for multifocal papillary thyroid cancer. These findings challenge traditional treatment paradigms and open new avenues for less invasive management strategies.’
Microwave ablation’s success in offering similar survival rates with fewer complications and the potential for preserving thyroid function signifies a significant advancement in interventional thyroid cancer treatment.
Dr Yu added: ‘Microwave ablation offers a promising treatment option for multifocal papillary thyroid cancer, enhancing patients’ quality of life by minimising complications and preserving thyroid function.’
The study, published in Radiology, a journal of the Radiological Society of North America (RSNA), heralds a significant shift in the treatment landscape for PTC.
With its minimally invasive nature and promising outcomes, microwave ablation presents a compelling option for patients and surgeons
