A study measuring the efficacy of microwave ablation (MWA) for the treatment of multifocal papillary thyroid carcinoma (PTC) found no difference in progression-free survival rate when compared to surgical resection. The results suggest MWA may be a safer alternative treatment for PTC, as it is minimally invasive and has fewer serious side effects. The full findings are published in Radiology. [1]
“MWA is currently under preliminary investigation for the treatment of multifocal PTC and has shown promising treatment efficacy. Compared with surgical resection, MWA is minimally invasive and could preserve thyroid function,” the authors led by Zhen-Long Zhao, MD, from the China-Japan Friendship Hospital in Beijing wrote.
The comparative study involved 10 medical centers, comprising 775 patients with PTC. The cohort were all treated using either MWA or surgery between May 2015 and December 2021, and the researchers used data on their rates of complication and survival for the analysis. After propensity score matching, the team found no evidence of differences in overall and 1-, 3-, or 5-year progression-free survival rates (all P > .05) between the MWA and surgical resection groups (5-year survival rate, 77.2% vs. 83.1%; P = .36), indicating that MWA is an effective treatment option for some patients.
After their procedures, 229 patients from the MWA group and the 453 who had surgery were monitored for 20 and 26 months, respectively, to measure complications. The researchers found that MWA procedures carried fewer incidents of blood loss, required smaller incisions, and ultimately reduced both procedure time and hospital length of stay. While some patients reported hoarseness after the procedure, it was never permanent and there was no post-procedure diagnosis of hypothyroidism. However, both were seen in patients who had surgery.
While the study results are promising, the authors note the sample size is relatively small and is subject to selection bias stemming from record availability. Secondly, the follow-up time was relatively short, indicating that side effects from surgery found to be permanent may, in fact, dissipate over time.
Most importantly, the study was not able to come to any firm conclusions on when surgery vs. MWA would be the best treatment for patients, as data on the pathological subtype of PTC was not obtained from the MWA group.
The authors emphasize the need for further studies to confirm these findings. However, the similar survival rates of patients and the reduction in measured side effects show MWA is an effective, safer treatment for some PTC patients.
The full study is available at the link below.
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