A 10-center study has found that microwave ablation offers progression-free survival rates and fewer complications compared to surgery in treating papillary thyroid carcinoma (PTC), according to research published today in *Radiology*, a journal of the Radiological Society of North America (RSNA).
PTC, the most common type of thyroid cancer, often presents with multifocality, where two or more nodules are found within the thyroid gland. This condition is frequent, occurring in approximately 23.5% to 60% of PTC cases.
Multifocal PTC is usually treated with surgical resection, involving the removal of all or part of the thyroid, which can lead to side effects such as scarring, lifelong hormone replacement, and complications like permanent hoarseness or impaired thyroid function.
Microwave ablation, a minimally invasive procedure using heat to destroy tumors, is under preliminary investigation as a potential alternative to surgery for some patients.
“This study marks the first multicenter comparative analysis between microwave ablation and surgical resection for multifocal papillary thyroid cancer,” said senior author Ming-An Yu, M.D., director of interventional medicine at China-Japan Friendship Hospital in Beijing, China. “These findings challenge traditional treatment paradigms and open new avenues for less invasive management strategies.”
Researchers studied 775 patients with ultrasound-detected multifocal Stage I PTC treated with microwave ablation or surgery across 10 centers from May 2015 to December 2021. They used propensity score matching to compare groups with different baseline characteristics, reducing bias and allowing for a more reliable assessment of treatment effects.
After matching, 229 patients in the microwave ablation group and 453 in the surgical resection group were followed for a median of 20 months (range 12-74 months) and 26 months (range 12-64 months), respectively.
Microwave ablation showed similar progression-free survival rates to surgery (5-year: 77.2% vs. 83.1%) but with fewer complications and better potential for preserving thyroid function. It resulted in less blood loss, shorter incision length, and shorter procedure and hospitalization durations. Complications like permanent hoarseness (2.2%) and hypoparathyroidism (4.0%) occurred only in the surgical resection group.
“Our study has shown that microwave ablation offers a promising treatment option for multifocal papillary thyroid cancer,” Dr. Yu said. “Additionally, microwave ablation is associated with fewer complications and can preserve thyroid function, thereby enhancing patients’ quality of life. This represents a significant advancement in the field of interventional thyroid cancer treatment.”
Dr. Yu notes that microwave ablation does not typically include preventative lymph node ablation, unlike surgical resection. However, the study provides the first evidence that even without lymph node ablation, microwave ablation yielded comparable survival rates to surgical resection.
