The following is a summary of “Three-year follow-up results of radiofrequency ablation for low-risk papillary thyroid microcarcinomas: systematic review and meta-analysis,” published in the June 2024 issue of Surgery by Xu et al.
This meta-analysis comprehensively evaluates the extended-term efficacy and safety profile of radiofrequency ablation (RFA) in managing papillary thyroid microcarcinoma (PTMC), aiming to elucidate its comparative benefits against surgical intervention and active surveillance (AS). The study systematically reviewed data from Ovid PUBMED, COCHRANE, and EMBASE databases up to November 19, 2023, identifying studies that reported outcomes in patients with PTMC treated with RFA and followed for over three years. Key endpoints included changes in tumor volume pre- and post-RFA, rates of tumor recurrence, occurrences of lymph node (LN) and distant metastases, the incidence of complications, and pooled volume reduction rates (VRRs) at intervals up to 48 months post-RFA.
The analysis included eight studies comprising 2,131 patients meeting inclusion criteria. At the final follow-up, the overall VRR was exceptionally high at 99.81% (95% CI: 99.68, 99.95), underscoring RFA’s efficacy in achieving substantial tumor shrinkage. Over an average follow-up period of 46.59 months, 69 patients experienced local PTMC recurrence, 8 cases were confined within the ablation zone, 44 patients were newly diagnosed with PTMC, and 17 exhibited LN metastases. Notably, among those experiencing recurrence, only 3 were managed under AS, with 59 opting for additional RFA treatment. The pooled complication rate was relatively low at 2.80%, without reports of severe or delayed complications, affirming RFA’s safety profile.
In summary, these findings highlight RFA as a highly effective strategy for local control of low-risk PTMC. It delivers enduring volume reduction and demonstrates lower recurrence and retreatment rates compared to conventional treatments, thus advocating for its consideration as a preferred therapeutic option in clinical practice.
Source: sciencedirect.com/science/article/abs/pii/S0748798324005225
