Skip to main content
Top
Published in:

03-01-2024 | Interventional

Radiofrequency ablation for capsular-located versus noncapsular-located papillary thyroid microcarcinoma: a propensity score matching study of 1095 patients

Authors: Haoyu Jing, Lin Yan, Jing Xiao, Xinyang Li, Bo Jiang, Zhen Yang, Mingbo Zhang, Yukun Luo

Published in: European Radiology | Issue 7/2024

Login to get access

Abstract

Objectives

To assess the safety and efficacy of radiofrequency ablation (RFA) for capsular-located papillary thyroid microcarcinoma (PTMC) in a large cohort and to compare its outcomes with those of noncapsular-located PTMC.

Methods

We retrospectively reviewed patients who underwent RFA for solitary capsular-located and noncapsular-located low-risk PTMC (n = 1095) from June 2014 to October 2020. To balance confounding variables between capsular and noncapsular groups, we employed the 1:1 propensity score matching approach. We evaluated and compared tumor changes, disease progression, and complications in both groups. Furthermore, we analyzed the association between capsular location and disease progression using multivariable Cox regression.

Results

During a mean follow-up time of 29.86 ± 16.14 months and 29.73 ± 15.69 months, no substantial difference was observed between capsular and noncapsular groups in the latest volume (0.83 ± 3.66 mm3 vs. 0.85 ± 3.67 mm3, p = 0.44) and volume reduction ratio (99.29 ± 4.04% vs. 99.43 ± 3.03%, p = 0.43), and cumulative disappearance rate (87.87% vs. 86.07%, p = 0.31). In addition, no significant differences were observed in complication incidence (1.35% vs. 1.12%, p = 0.76) and progression-free survival (p = 0.53). Based on adjusted multivariate Cox proportional hazard analysis, the association between capsular location and disease progression was nonsignificant (all p > 0.05).

Conclusion

This study demonstrates that the short-term outcomes of RFA for capsular-located PTMCs are comparable to those of noncapsular-located PTMCs. These findings indicate that RFA may be a viable and effective alternative for eligible patients with solitary capsular-located PTMC.

Clinical relevance statement

Radiofrequency ablation may serve as a safe and effective alternative treatment method for eligible patients with capsular-located and noncapsular-located papillary thyroid microcarcinoma.

Key Points

• The safety and efficacy of radiofrequency ablation for capsular-located and noncapsular-located papillary thyroid microcarcinomas were comparable.
• Disease progression did not differ significantly between capsular-located and noncapsular-located papillary thyroid microcarcinomas.
• The incidence of complications for capsular-located papillary thyroid microcarcinoma was low.
Appendix
Available only for authorised users
Literature
1.
go back to reference Pizzato M, Li M, Vignat J et al (2022) The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 10:264–272CrossRefPubMed Pizzato M, Li M, Vignat J et al (2022) The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 10:264–272CrossRefPubMed
2.
3.
go back to reference Li M, Brito JP, Vaccarella S (2020) Long-term declines of thyroid cancer mortality: an international age-period-cohort analysis. Thyroid 30:838–846CrossRefPubMed Li M, Brito JP, Vaccarella S (2020) Long-term declines of thyroid cancer mortality: an international age-period-cohort analysis. Thyroid 30:838–846CrossRefPubMed
4.
go back to reference Tuttle RM, Haugen B, Perrier ND (2017) Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for differentiated and anaplastic thyroid cancer (eighth edition): what changed and why? Thyroid 27:751–756CrossRefPubMedPubMedCentral Tuttle RM, Haugen B, Perrier ND (2017) Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for differentiated and anaplastic thyroid cancer (eighth edition): what changed and why? Thyroid 27:751–756CrossRefPubMedPubMedCentral
5.
go back to reference Miranda-Filho A, Lortet-Tieulent J, Bray F et al (2021) Thyroid cancer incidence trends by histology in 25 countries: a population-based study. Lancet Diabetes Endocrinol 9:225–234CrossRefPubMed Miranda-Filho A, Lortet-Tieulent J, Bray F et al (2021) Thyroid cancer incidence trends by histology in 25 countries: a population-based study. Lancet Diabetes Endocrinol 9:225–234CrossRefPubMed
6.
go back to reference Cao XJ, Wang SR, Che Y et al (2021) Efficacy and safety of thermal ablation for treatment of solitary T1N0M0 papillary thyroid carcinoma: a multicenter retrospective study. Radiology 300:209–216CrossRefPubMed Cao XJ, Wang SR, Che Y et al (2021) Efficacy and safety of thermal ablation for treatment of solitary T1N0M0 papillary thyroid carcinoma: a multicenter retrospective study. Radiology 300:209–216CrossRefPubMed
7.
go back to reference vanSonnenberg E, Simeone JF (2022) Microwave ablation versus surgery for papillary thyroid carcinoma: more therapeutic options, more controversies. Radiology 304:714–715CrossRefPubMed vanSonnenberg E, Simeone JF (2022) Microwave ablation versus surgery for papillary thyroid carcinoma: more therapeutic options, more controversies. Radiology 304:714–715CrossRefPubMed
8.
go back to reference Cho SJ, Baek SM, Na DG, Lee KD, Shong YK, Baek JH (2021) Five-year follow-up results of thermal ablation for low-risk papillary thyroid microcarcinomas: systematic review and meta-analysis. Eur Radiol 31:6446–6456CrossRefPubMed Cho SJ, Baek SM, Na DG, Lee KD, Shong YK, Baek JH (2021) Five-year follow-up results of thermal ablation for low-risk papillary thyroid microcarcinomas: systematic review and meta-analysis. Eur Radiol 31:6446–6456CrossRefPubMed
9.
go back to reference van Dijk SPJ, Coerts HI, Gunput STG et al (2022) Assessment of radiofrequency ablation for papillary microcarcinoma of the thyroid: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 148:317–325CrossRefPubMedPubMedCentral van Dijk SPJ, Coerts HI, Gunput STG et al (2022) Assessment of radiofrequency ablation for papillary microcarcinoma of the thyroid: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 148:317–325CrossRefPubMedPubMedCentral
10.
go back to reference Orloff LA, Noel JE, Stack BC Jr et al (2022) Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: an international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck 44:633–660CrossRefPubMed Orloff LA, Noel JE, Stack BC Jr et al (2022) Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: an international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck 44:633–660CrossRefPubMed
11.
go back to reference Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133CrossRefPubMedPubMedCentral Haugen BR, Alexander EK, Bible KC et al (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133CrossRefPubMedPubMedCentral
12.
go back to reference Li W, Li Y, Long M, Li J, Ma J, Luo Y (2023) Vascularity depicted by contrast-enhanced ultrasound predicts recurrence of papillary thyroid cancer. Eur J Radiol 159:110667CrossRefPubMed Li W, Li Y, Long M, Li J, Ma J, Luo Y (2023) Vascularity depicted by contrast-enhanced ultrasound predicts recurrence of papillary thyroid cancer. Eur J Radiol 159:110667CrossRefPubMed
14.
go back to reference Zheng L, Dou JP, Liu FY et al (2023) Microwave ablation vs. surgery for papillary thyroid carcinoma with minimal sonographic extrathyroid extension: a multicentre prospective study. Eur Radiol 33:233–243CrossRefPubMed Zheng L, Dou JP, Liu FY et al (2023) Microwave ablation vs. surgery for papillary thyroid carcinoma with minimal sonographic extrathyroid extension: a multicentre prospective study. Eur Radiol 33:233–243CrossRefPubMed
15.
go back to reference Chung SR, Baek JH, Choi YJ et al (2020) Sonographic assessment of the extent of extrathyroidal extension in thyroid cancer. Korean J Radiol 21:1187–1195CrossRefPubMedPubMedCentral Chung SR, Baek JH, Choi YJ et al (2020) Sonographic assessment of the extent of extrathyroidal extension in thyroid cancer. Korean J Radiol 21:1187–1195CrossRefPubMedPubMedCentral
16.
go back to reference Lamartina L, Bidault S, Hadoux J et al (2021) Can preoperative ultrasound predict extrathyroidal extension of differentiated thyroid cancer? Eur J Endocrinol 185:13–22CrossRefPubMed Lamartina L, Bidault S, Hadoux J et al (2021) Can preoperative ultrasound predict extrathyroidal extension of differentiated thyroid cancer? Eur J Endocrinol 185:13–22CrossRefPubMed
17.
go back to reference Zhang M, Luo Y, Zhang Y, Tang J (2016) Efficacy and safety of ultrasound-guided radiofrequency ablation for treating low-risk papillary thyroid microcarcinoma: a prospective study. Thyroid 26:1581–1587CrossRefPubMed Zhang M, Luo Y, Zhang Y, Tang J (2016) Efficacy and safety of ultrasound-guided radiofrequency ablation for treating low-risk papillary thyroid microcarcinoma: a prospective study. Thyroid 26:1581–1587CrossRefPubMed
18.
go back to reference Mauri G, Pacella CM, Papini E et al (2019) Image-guided thyroid ablation: proposal for standardization of terminology and reporting criteria. Thyroid 29:611–618CrossRefPubMed Mauri G, Pacella CM, Papini E et al (2019) Image-guided thyroid ablation: proposal for standardization of terminology and reporting criteria. Thyroid 29:611–618CrossRefPubMed
19.
go back to reference Akbulut D, Kuz ED, Kursun N, Dizbay Sak S (2021) Capsular invasion matters also in “papillary patterned” tumors: a study on 121 cases of encapsulated conventional variant of papillary thyroid carcinoma. Endocr Pathol 32:357–367CrossRefPubMed Akbulut D, Kuz ED, Kursun N, Dizbay Sak S (2021) Capsular invasion matters also in “papillary patterned” tumors: a study on 121 cases of encapsulated conventional variant of papillary thyroid carcinoma. Endocr Pathol 32:357–367CrossRefPubMed
20.
go back to reference Kim WY, Kim HY, Son GS, Bae JW, Lee JB (2014) Clinicopathological, immunohistochemical factors and recurrence associated with extrathyroidal extension in papillary thyroid microcarcinoma. J Cancer Res Ther 10:50–55CrossRefPubMed Kim WY, Kim HY, Son GS, Bae JW, Lee JB (2014) Clinicopathological, immunohistochemical factors and recurrence associated with extrathyroidal extension in papillary thyroid microcarcinoma. J Cancer Res Ther 10:50–55CrossRefPubMed
21.
go back to reference Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17:1471–1474 Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17:1471–1474
22.
go back to reference Tam S, Amit M, Boonsripitayanon M et al (2018) Effect of tumor size and minimal extrathyroidal extension in patients with differentiated thyroid cancer. Thyroid 28:982–990CrossRefPubMed Tam S, Amit M, Boonsripitayanon M et al (2018) Effect of tumor size and minimal extrathyroidal extension in patients with differentiated thyroid cancer. Thyroid 28:982–990CrossRefPubMed
23.
go back to reference Su HK, Wenig BM, Haser GC et al (2016) Inter-observer variation in the pathologic identification of minimal extrathyroidal extension in papillary thyroid carcinoma. Thyroid 26:512–517CrossRefPubMedPubMedCentral Su HK, Wenig BM, Haser GC et al (2016) Inter-observer variation in the pathologic identification of minimal extrathyroidal extension in papillary thyroid carcinoma. Thyroid 26:512–517CrossRefPubMedPubMedCentral
24.
go back to reference Yan L, Lan Y, Xiao J, Lin L, Jiang B, Luo Y (2021) Long-term outcomes of radiofrequency ablation for unifocal low-risk papillary thyroid microcarcinoma: a large cohort study of 414 patients. Eur Radiol 31:685–694CrossRefPubMed Yan L, Lan Y, Xiao J, Lin L, Jiang B, Luo Y (2021) Long-term outcomes of radiofrequency ablation for unifocal low-risk papillary thyroid microcarcinoma: a large cohort study of 414 patients. Eur Radiol 31:685–694CrossRefPubMed
25.
go back to reference Wei Y, Niu WQ, Zhao ZL et al (2022) Microwave ablation versus surgical resection for solitary T1N0M0 papillary thyroid carcinoma. Radiology 304:704–713CrossRefPubMed Wei Y, Niu WQ, Zhao ZL et al (2022) Microwave ablation versus surgical resection for solitary T1N0M0 papillary thyroid carcinoma. Radiology 304:704–713CrossRefPubMed
26.
go back to reference Wang QC, Cheng W, Wen X, Li JB, Jing H, Nie CL (2014) Shorter distance between the nodule and capsule has greater risk of cervical lymph node metastasis in papillary thyroid carcinoma. Asian Pac J Cancer Prev 15:855–860CrossRefPubMed Wang QC, Cheng W, Wen X, Li JB, Jing H, Nie CL (2014) Shorter distance between the nodule and capsule has greater risk of cervical lymph node metastasis in papillary thyroid carcinoma. Asian Pac J Cancer Prev 15:855–860CrossRefPubMed
27.
go back to reference Li G, Li R, Song L et al (2020) Implications of extrathyroidal extension invading only the strap muscles in papillary thyroid carcinomas. Thyroid 30:57–64CrossRefPubMed Li G, Li R, Song L et al (2020) Implications of extrathyroidal extension invading only the strap muscles in papillary thyroid carcinomas. Thyroid 30:57–64CrossRefPubMed
28.
go back to reference Ywata de Carvalho A, Chulam TC, Kowalski LP (2015) Long-term results of observation vs prophylactic selective level VI neck dissection for papillary thyroid carcinoma at a cancer center. JAMA Otolaryngol Head Neck Surg 141:599–606CrossRefPubMed Ywata de Carvalho A, Chulam TC, Kowalski LP (2015) Long-term results of observation vs prophylactic selective level VI neck dissection for papillary thyroid carcinoma at a cancer center. JAMA Otolaryngol Head Neck Surg 141:599–606CrossRefPubMed
29.
go back to reference Chung SR, Baek JH, Choi YJ, Lee JH (2019) Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. Eur Radiol 29:4897–4903CrossRefPubMed Chung SR, Baek JH, Choi YJ, Lee JH (2019) Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. Eur Radiol 29:4897–4903CrossRefPubMed
30.
go back to reference Xue J, Teng D, Wang H (2022) Efficacy and safety of ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma: a systematic review and meta-analysis. Int J Hyperthermia 39:1300–1309CrossRefPubMed Xue J, Teng D, Wang H (2022) Efficacy and safety of ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma: a systematic review and meta-analysis. Int J Hyperthermia 39:1300–1309CrossRefPubMed
31.
go back to reference Choi Y, Jung SL (2020) Efficacy and safety of thermal ablation techniques for the treatment of primary papillary thyroid microcarcinoma: a systematic review and meta-analysis. Thyroid 30:720–731CrossRefPubMed Choi Y, Jung SL (2020) Efficacy and safety of thermal ablation techniques for the treatment of primary papillary thyroid microcarcinoma: a systematic review and meta-analysis. Thyroid 30:720–731CrossRefPubMed
32.
go back to reference Hayward NJ, Grodski S, Yeung M, Johnson WR, Serpell J (2013) Recurrent laryngeal nerve injury in thyroid surgery: a review. ANZ J Surg 83:15–21CrossRefPubMed Hayward NJ, Grodski S, Yeung M, Johnson WR, Serpell J (2013) Recurrent laryngeal nerve injury in thyroid surgery: a review. ANZ J Surg 83:15–21CrossRefPubMed
33.
go back to reference Zhang Y, Zhang X, Li J, Cai Q, Qiao Z, Luo YK (2021) Contrast-enhanced ultrasound: a valuable modality for extracapsular extension assessment in papillary thyroid cancer. Eur Radiol 31:4568–4575CrossRefPubMed Zhang Y, Zhang X, Li J, Cai Q, Qiao Z, Luo YK (2021) Contrast-enhanced ultrasound: a valuable modality for extracapsular extension assessment in papillary thyroid cancer. Eur Radiol 31:4568–4575CrossRefPubMed
Metadata
Title
Radiofrequency ablation for capsular-located versus noncapsular-located papillary thyroid microcarcinoma: a propensity score matching study of 1095 patients
Authors
Haoyu Jing
Lin Yan
Jing Xiao
Xinyang Li
Bo Jiang
Zhen Yang
Mingbo Zhang
Yukun Luo
Publication date
03-01-2024
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-10490-w