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The following is a summary of “Therapeutic outcomes and safety of radiofrequency ablation for primary papillary thyroid carcinoma: A game-changing meta-analysis,” published in the February 2025 issue of Oncology by Toraih et al.

Radiofrequency ablation (RFA) is an emerging minimally invasive treatment option for small, low-risk papillary thyroid carcinoma (PTC). This systematic review and meta-analysis evaluated the efficacy and safety of RFA in treating primary T1a and T1b PTC without nodal or distant metastases, comparing key clinical outcomes between these tumor subtypes. The primary endpoints were pooled proportions of tumor disappearance, volume reduction, complications, and recurrence.

About 20 studies comprising 6,613 RFA-treated PTC nodules were included, with a median patient age of 44 years and an average follow-up duration of 36.4 months. The mean tumor volume and diameter were 168.9 mm³ and 0.69 cm, respectively. The overall pooled tumor disappearance rate was 94.3%, with significantly higher rates for T1a lesions (96.1%) compared to T1b lesions (76.7%, p = 0.05). Tumor disappearance increased over time, from 61.8% at 12 months to 91.5% at 48 months post-RFA. The VRR for all tumors was 99.4%, with progressive improvement from 36.8% at 1 month to 99.6% at 48 months.

Tumor progression occurred in only 1.33% of cases, with recurrence rates of 1.11% in T1a and 4.21% in T1b tumors. New cancer foci and lymph node metastases were rare, observed in 0.81% and 0.20% of cases, respectively. RFA demonstrated a favorable safety profile, with an overall complication rate of 1.71%. The most common complications were transient voice changes (0.44%) and neck pain (0.30%).

These findings suggest that RFA is a safe and effective treatment for both T1a and T1b PTC, with excellent tumor disappearance and volume reduction rates, low recurrence rates, and minimal complications. The comparable outcomes between T1a and T1b tumors highlight RFA’s potential as a viable alternative to surgery for selected patients with low-risk PTC. Further prospective studies with standardized protocols are needed to confirm these results and refine patient selection criteria, ensuring the broader clinical applicability of RFA in managing low-risk PTC.

Source: sciencedirect.com/science/article/pii/S0167814025000015