Clinical outcomes of microwave ablation for solitary T1N0M0 papillary thyroid carcinoma: a more than 5-year follow-up study

ObjectivesThis study aimed to evaluate the long-term efficacy and safety of microwave ablation (MWA) for solitary T1N0M0 papillary thyroid carcinoma (PTC) and compare them between T1a and T1b disease.Materials and methodsThis retrospective study included 136 patients with solitary T1N0M0 PTC who were treated with MWA and followed up for more than 5 years. Outcomes were compared between patients with T1a and T1b disease. The primary outcomes were disease progression and disease-free survival (DFS). The secondary outcomes included the volume reduction rate (VRR), the rate of complete disappearance, and complications.ResultsDuring a mean follow-up period of 70.6 +/- 10.5 months, the overall disease progression rate was 5.88%. The incidences of lymph node metastases (LNMs) and new tumors were 2.21% and 5.15%, respectively. No patient was diagnosed with local recurrence, distant metastasis, or death due to PTC. There were no significant differences between the T1a and T1b groups in terms of disease progression (3.81% vs 12.90%, p = 0.15), LNMs (1.90% vs 3.23%, p = 0.54), or new tumors (2.86% vs 12.90%, p = 0.08). The 5-year DFS rate was 94.85%, the VRR was 99.7% +/- 2.0%, and 97.79% of the tumors disappeared. Hoarseness occurred in five patients (3.68%).ConclusionMWA is a long-term effective and safe option for patients with solitary T1N0M0 PTC, providing a minimally invasive alternative for those who refuse surgery or active surveillance.Key PointsQuestionMWA, as a minimally invasive alternative for treating PTC, lacks comparison with surgical resection and active surveillance.FindingsMWA resulted in overall disease progression in 5.88% of patients with solitary T1N0M0 PTC over more than 5 years of follow-up.Clinical relevanceMWA is a safe, effective, and minimally invasive treatment for solitary T1N0M0 PTC, with high DFS rates and low complication rates, benefiting patients seeking alternatives to surgery or active surveillance.Key PointsQuestionMWA, as a minimally invasive alternative for treating PTC, lacks comparison with surgical resection and active surveillance.FindingsMWA resulted in overall disease progression in 5.88% of patients with solitary T1N0M0 PTC over more than 5 years of follow-up.Clinical relevanceMWA is a safe, effective, and minimally invasive treatment for solitary T1N0M0 PTC, with high DFS rates and low complication rates, benefiting patients seeking alternatives to surgery or active surveillance.Key PointsQuestionMWA, as a minimally invasive alternative for treating PTC, lacks comparison with surgical resection and active surveillance.FindingsMWA resulted in overall disease progression in 5.88% of patients with solitary T1N0M0 PTC over more than 5 years of follow-up.Clinical relevanceMWA is a safe, effective, and minimally invasive treatment for solitary T1N0M0 PTC, with high DFS rates and low complication rates, benefiting patients seeking alternatives to surgery or active surveillance.