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Five-year follow-up results of thermal ablation for low-risk papillary thyroid microcarcinomas: systematic review and meta-analysis

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Abstract

Objectives

Confidence in long-term treatment results of thermal ablation for papillary thyroid microcarcinoma (PTMC) is required in comparison with active surveillance. The objective of this meta-analysis is to report 5-year follow-up results of thermal ablation for PTMC.

Methods

Ovid MEDLINE and EMBASE databases were searched through May 30, 2020, for studies reporting outcomes in patients with PTMC treated with thermal ablation and followed up for at least 5 years. Data were extracted and methodological quality was assessed independently by two radiologists according to the PRISMA guidelines.

Results

Three studies, involving 207 patients with 219 PTMCs, met the inclusion criteria through database searches. None of these patients experienced local tumor recurrence, lymph node metastasis, or distant metastasis or underwent delayed surgery during a mean pooled 67.8-month follow-up. Five new tumors appeared in the remaining thyroid gland of four patients, with four of these tumors successfully treated by repeat thermal ablation. The pooled mean major complication rate was 1.2%, with no patient experiencing life-threatening or delayed complications.

Conclusions

Thermal ablation is an excellent local tumor control method in patients with low-risk PTMC, with low major complication rates at 5 years.

Key Points

• No local tumor recurrence, lymph node metastasis, or distant metastasis was noted by thermal ablation during follow-up of 5 years and none underwent delayed surgery.

• The pooled mean major complication rate was 1.2%.

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Abbreviations

AS:

Active surveillance

ATA:

American Thyroid Association

CNB:

Core-needle biopsy

FNA:

Fine-needle aspiration

LN:

Lymph node

MWA:

Microwave ablation

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

PTMC:

Papillary thyroid microcarcinoma

RFA:

Radiofrequency ablation

US:

Ultrasound

VRR:

Volume reduction rate

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi, Republic of Korea

    Se Jin Cho

  2. Department of Radiology, Haeundae Sharing and Happiness Hospital, 502, Jwadongsunhwan-ro, Haeundae-gu, Busan, 48101, Republic of Korea

    Sun Mi Baek

  3. Department of Radiology, GangNeung Asan Hospital, Gangneung, Republic of Korea

    Dong Gyu Na

  4. Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea

    Dong Gyu Na

  5. Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Republic of Korea

    Kang Dae Lee

  6. Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Young Kee Shong

  7. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea

    Jung Hwan Baek

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  1. Se Jin Cho
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Correspondence to Jung Hwan Baek.

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The scientific guarantor of this publication is Jung Hwan Baek.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Se Jin Cho) has significant statistical expertise.

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Written informed consent was not required for this study because this article is a systematic review and meta-analysis.

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Institutional Review Board approval was not required because this article is a systematic review and meta-analysis.

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Cho, S.J., Baek, S.M., Na, D.G. et al. Five-year follow-up results of thermal ablation for low-risk papillary thyroid microcarcinomas: systematic review and meta-analysis. Eur Radiol 31, 6446–6456 (2021). https://doi.org/10.1007/s00330-021-07808-x

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