A new 10-center study highlights microwave ablation as a promising alternative to surgery for patients with multifocal papillary thyroid carcinoma (PTC), the most common form of thyroid cancer. Published in Radiology by the Radiological Society of North America (RSNA), the research reveals that microwave ablation—a minimally invasive procedure using heat to destroy tumors—can offer comparable progression-free survival rates to traditional surgery but with fewer complications. This finding is particularly significant as multifocality, or the presence of multiple nodules in the thyroid gland, affects 23.5% to 60% of PTC cases, typically requiring surgical resection, which may carry risks like scarring, potential for permanent hoarseness, and lifelong hormone replacement therapy. By contrast, microwave ablation presents fewer side effects, preserving thyroid function and enhancing quality of life.
The study, led by Dr. Ming-An Yu from China-Japan Friendship Hospital in Beijing, examined 775 patients with ultrasound-detected multifocal Stage I PTC treated either by microwave ablation or surgery. Using a propensity score matching approach, which helps balance baseline characteristics across groups, researchers evaluated 229 patients undergoing microwave ablation against 453 who received surgery, with follow-up times averaging 20 and 26 months, respectively. Results showed that five-year progression-free survival rates were similar between microwave ablation (77.2%) and surgery (83.1%). Additionally, microwave ablation resulted in less blood loss, smaller incisions, and shorter procedure and recovery times. Notably, complications such as permanent hoarseness and hypoparathyroidism only occurred in the surgical group.
This study marks the first multicenter comparison of microwave ablation and surgery for multifocal PTC. Although routine lymph node ablation is standard in surgical treatment, microwave ablation, without lymph node removal, yielded equivalent survival outcomes, signaling a potential shift in treatment options for thyroid cancer patients. Dr. Yu emphasized that microwave ablation not only reduces complication risks but also aligns with a less invasive approach, representing a promising advance in interventional thyroid cancer care.
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