Long-term outcomes of radiofrequency ablation versus surgery for bilateral multifocal (≤3) T1N0M0 papillary thyroid carcinoma: A retrospective cohort study.

Abstract

This study compared long-term outcomes of ultrasound-guided radiofrequency ablation versus total thyroidectomy for bilateral multifocal (≤3) T1N0M0 papillary thyroid carcinoma. In this retrospective cohort study, 125 patients with bilateral multifocal T1N0M0 papillary thyroid carcinoma treated between June 2018 and August 2020 were consecutively included. Among them, 55 underwent radiofrequency ablation and 70 underwent total thyroidectomy. All patients underwent total thyroidectomy with prophylactic central neck dissection. Outcomes included tumor progression, complications, costs, and quality of life. After a mean follow-up of 69.3 ± 6.9 months in the radiofrequency ablation group and 66.8 ± 7.9 months in the total thyroidectomy group, the tumor progression rates of the 2 groups were 7.3% and 2.9%, and the study was severely underpowered (16%) to detect a difference in recurrence. Compared with the total thyroidectomy group, the radiofrequency ablation group demonstrated significant advantages in hospital stay (0 day vs 7 days, P< .001), procedure time (16.5 min vs 90 min; P< .001), intraoperative blood loss (0 vs 20 mL; P< .001), procedure cost (¥15,877.1 vs ¥5,065.4; P< .001), complication rate (0% vs 25.7%; P< .001), and quality-of-life scores (13.1 vs 14.8; P< .001). No significant predictors of tumor progression were identified from the clinical or sonographic characteristics of the dominant lesions. For selected patients with bilateral multifocal (≤3) T1N0M0 papillary thyroid carcinoma, radiofrequency ablation appears to be a promising minimally invasive option, associated with less trauma, lower cost, fewer complications, and better life quality.