目的 对诊断为甲状腺乳头状癌 (PTC) 的患者进行热消融和手术干预的疗效、安全性及其对生活质量的影响进行比较分析。进行了一项前瞻性研究，纳入接受射频治疗的 PTC ≤ 5mm 的患者消融 (RFA)、激光消融 (LA) 或手术，用于分析疗效和安全性结果。所有患者在治疗前以及治疗后 3、6 和 12 个月时均接受了甲状腺癌特定生活质量调查问卷。该研究总共纳入了 162 名符合条件的患者。 RFA 和 LA 组未观察到主要并发症，而手术组报告了 5 例，但没有观察到统计学上的显着差异。 RFA、LA 和手术组分别有 2 名、3 名和 14 名患者出现轻微并发症，没有发现显着差异。热消融组的手术时间和住院时间明显较短。在最后一次随访中，接受 RFA 治疗的病例中有 71.4% 的结节完全消失，接受 LA 治疗的病例中有 71.0% 的结节完全消失，两组之间没有显着差异。 RFA 和 LA 对生活质量的影响相似，与手术相比，热消融技术显示出更好的功能结果。在所有组中，不良反应在治疗后 3 个月时最为明显，但与手术组相比，热消融组逐渐恢复到基线水平。对于 PTC ≤ 5mm，RFA 和 LA 都表现出相似的癌症控制结果和与手术相当的卓越生活质量，同时最大限度地减少并发症。这些发现强调了 RFA 和 LA 作为小型 PTC 潜在标准治疗的前景，有待未来研究的进一步证实。版权所有 © 2024 龚、张、张、翟、郑和张。

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.Copyright © 2024 Gong, Zhang, Zhang, Zhai, Zheng and Zhang.