低风险乳头状甲状腺癌的热消融和手术之间的比较：一项前瞻性研究
Comparison between thermal ablation and surgery in low risk papillary thyroid carcinoma: a prospective study
影响因子:4.60000
分区:医学3区 / 内分泌学与代谢3区
发表日期:2024
作者:
Wenbo Gong, Runfang Zhang, Songtao Zhang, Yifei Zhai, Chen Zheng, Dongyan Zhang
摘要
To conduct a comparative analysis of the efficacy, safety, and impact on quality of life outcomes between thermal ablation and surgical interventions in patients diagnosed with papillary thyroid carcinoma (PTC).A prospective study was undertaken, enrolling patients with PTC ≤5mm who underwent radiofrequency ablation (RFA), laser ablation (LA), or surgery, for analysis of efficacy and安全结果。治疗后3、6和12个月，对所有患者进行了甲状腺癌特异性的生活质量问卷。该研究总共包括162名合格的患者。在RFA和LA组中未观察到重大并发症，而在手术组中报告了五例，尽管没有观察到统计学上的显着差异。在RFA，LA和手术组中分别记录了两者，三名和14例患者的较小并发症，没有明显的差异。在热消融组中，手术持续时间和住院时间明显更短。在最后的随访中，在用RFA治疗的病例中，有71.4％的结节完全消失，其中71.0％的病例用LA处理，两组之间没有显着差异。 RFA和LA都对生活质量均表现出相似的影响，与手术相比，热消融技术表现出更好的功能结果。在所有组中，在3个月后的治疗标记中最明显的不良反应在热消融组中逐渐恢复到基线水平，与手术组相反。对于PTC≤5mm，RFA和LA都表现出相似的癌症控制成果和与手术相似的癌症控制成果，同时在手术中均具有较小的复杂性。这些发现强调了RFA和LA作为小型PTC的潜在标准治疗的希望，在未来的研究中需要进一步确认。
Abstract
To conduct a comparative analysis of the efficacy, safety, and impact on quality of life outcomes between thermal ablation and surgical interventions in patients diagnosed with papillary thyroid carcinoma (PTC).A prospective study was undertaken, enrolling patients with PTC ≤5mm who underwent radiofrequency ablation (RFA), laser ablation (LA), or surgery, for analysis of efficacy and safety outcomes. The Thyroid Cancer-Specific Quality of Life questionnaire was administered to all patients before treatment and at 3, 6, and 12 months post-treatment.A total of 162 eligible patients were included in the study. Major complications were not observed in the RFA and LA groups, while five cases were reported in the surgery group, although no statistically significant differences were observed. Minor complications were documented in two, three, and 14 patients in the RFA, LA, and surgery groups, respectively, with no significant variances noted. Surgical duration and hospitalization time were notably shorter in the thermal ablation groups. At the final follow-up, complete disappearance of nodules was seen in 71.4% of cases treated with RFA and 71.0% of cases managed with LA, with no significant disparities between the groups. Both RFA and LA exhibited similar effects on quality of life, with thermal ablation techniques showing better functional outcomes in comparison to surgery. Across all groups, adverse effects were most pronounced at the 3-month post-treatment mark but gradually reverted to baseline levels in the thermal ablation group, contrasting with the surgery group.For PTC ≤5mm, both RFA and LA exhibited similar cancer control outcomes and superior quality of life on par with surgery, while minimizing complications. These findings underscore the promise of RFA and LA as potential standard treatments for small PTCs, subject to further confirmation in future studies.