The following is a summary of “Five-year Outcome Between Radiofrequency Ablation vs Surgery for Unilateral Multifocal Papillary Thyroid Microcarcinoma,” published in the December 2023 issue of Endocrinology by Yan, et al.

Ultrasound (US)-guided radiofrequency ablation (RFA) is considered an alternative to surgery or active surveillance for papillary thyroid microcarcinoma (PTMC). There was limited knowledge about the long-term outcomes of RFA compared to surgery, specifically for unilateral multifocal PTMC. 

For a study, researchers sought to compare the outcomes of RFA versus surgery for unilateral multifocal PTMC over a follow-up period exceeding 5 years.

The retrospective study at a primary care center involved 97 patients with unilateral multifocal PTMC. Of these, 44 patients were treated with RFA (RFA group), and 53 underwent surgery (surgery group). RFA was performed using a bipolar RFA generator and an 18-gauge bipolar RF electrode, while surgery involved thyroid lobectomy with prophylactic central neck dissection.

Over the follow-up period (median: 72.9 months), there were no statistically significant differences between the RFA and surgery groups in disease progression (4.5% vs 3.8%; P = ≥.999), lymph node metastasis (2.3% vs 3.8%; P = ≥.999), persistent lesion (2.3% vs 0%; P = .272), and recurrence-free survival rates (97.7% vs 96.2%; P = .673). RFA-treated patients experienced shorter hospitalization (0 vs 8.0 [3.0] d; P < .001), procedure time (3.5 [2.4] vs 80.0 [35.0] min; P < .001), lower estimated blood loss (0 vs 20.0 [15.0] mL; P < .001), and lower costs ($1768.3 [0.1] vs $2084.4 [1173.8]; P = .001) compared to the surgery group. The complication rate in the surgery group was 7.5%, while no complications occurred in the RFA group (P = .111).

The study demonstrated comparable 6-year outcomes between RFA and surgery for unilateral multifocal PTMC. RFA appeared to be a safe and effective alternative to surgery in selected patients with unilateral multifocal PTMC.

Source: academic.oup.com/jcem/article-abstract/108/12/3230/7198576