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Chen Y, Li J, Zhao S, Zhang Z, Cai Y, Zhao H, Zhang X, Chen B. Ultrasound-Guided Thermal Ablation vs Surgery in T1N0M0 Papillary Thyroid Carcinoma: A Systematic Review and Meta-analysis. Acad Radiol 2025; 32:3291-3303. [PMID: 40113470 DOI: 10.1016/j.acra.2025.02.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2025] [Revised: 02/22/2025] [Accepted: 02/27/2025] [Indexed: 03/22/2025]
Abstract
RATIONALE AND OBJECTIVES Ultrasound-guided thermal ablation (TA) offers a minimally invasive alternative to surgery for T1N0M0 papillary thyroid carcinoma (PTC), but its efficacy and safety remain controversial. This meta-analysis aimed to evaluate and compare the outcomes of TA and surgery in treating T1N0M0 PTC, encompassing both T1a and T1b stages. MATERIALS AND METHODS We conducted a systematic review and meta-analysis including studies comparing TA and surgery for T1N0M0 PTC up to October 23, 2024. Standardized mean differences and odds ratios (OR) with 95% confidence intervals (CI) were calculated for primary and secondary outcomes. RESULTS Sixteen studies with a total of 5045 patients were analyzed. No significant differences were observed in recurrence (OR=1.464; 95% CI=0.881, 2.433; P=.141), lymph node metastasis (OR=0.817; 95% CI=0.492, 1.356; P=.434), transient hoarseness (OR=0.700; 95% CI=0.339, 1.445; P=.334), hematoma (OR=0.528; 95% CI=0.187, 1.492; P=.228), and infection (OR=0.368; 95% CI=0.060, 2.268; P=.281). Notably, TA significantly reduced permanent hoarseness, hypoparathyroidism, dysphagia, procedure time, hospitalization, cost, estimated blood loss, and surgical incision (all P<.05). The subgroup analyses demonstrated similar primary outcomes within each subgroup, including tumor stage (T1a/T1b), type of TA (microwave/radiofrequency), and follow-up time (short-term/long-term). CONCLUSION Ultrasound-guided TA is a safe and effective alternative to surgery for both T1a and T1b stages of T1N0M0 PTC, offering comparable prognostic outcomes with fewer complications, lower costs, and faster recovery.
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Affiliation(s)
- Yanwei Chen
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu 212000, China (Y.C., S.Z., Z.Z., Y.C., H.Z., X.Z., B.C.)
| | - Jianming Li
- Department of Interventional Ultrasound, PLA Medical College & 5th Medical Center of Chinese PLA General Hospital, Beijing, China (J.L.)
| | - Shuangshuang Zhao
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu 212000, China (Y.C., S.Z., Z.Z., Y.C., H.Z., X.Z., B.C.)
| | - Zheng Zhang
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu 212000, China (Y.C., S.Z., Z.Z., Y.C., H.Z., X.Z., B.C.)
| | - Yun Cai
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu 212000, China (Y.C., S.Z., Z.Z., Y.C., H.Z., X.Z., B.C.)
| | - Huajiao Zhao
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu 212000, China (Y.C., S.Z., Z.Z., Y.C., H.Z., X.Z., B.C.)
| | - Xin Zhang
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu 212000, China (Y.C., S.Z., Z.Z., Y.C., H.Z., X.Z., B.C.)
| | - Baoding Chen
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu 212000, China (Y.C., S.Z., Z.Z., Y.C., H.Z., X.Z., B.C.).
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Chen J, Shi X. Ultrasound-Guided Percutaneous Radiofrequency and Microwave Ablation for Lymph Node Recurrence of PTC. Acad Radiol 2025; 32:3136. [PMID: 39890523 DOI: 10.1016/j.acra.2025.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2025] [Revised: 01/16/2025] [Accepted: 01/16/2025] [Indexed: 02/03/2025]
Affiliation(s)
- Jisheng Chen
- Division of Molecular and Experimental Surgery, Translational Research Center, Department of Surgery, Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany (J.C.)
| | - Xinlong Shi
- Department of Medicine 1, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Kussmaulallee 4, Erlangen 91054, Germany (X.S.).
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