Efficacy and Safety of Different Thermal Ablation Modalities for Papillary Thyroid Microcarcinoma: A Network Meta-Analysis

TL;DR

This study compares different thermal ablation methods for treating small thyroid cancer and finds variations in effectiveness and safety.

Contribution

A network meta-analysis comparing the efficacy and safety of various thermal ablation modalities for papillary thyroid microcarcinoma.

Findings

No significant difference in recurrence rates among thermal ablation methods.

Surgery had the lowest recurrence rate, while laser ablation had the fewest complications.

Radiofrequency ablation resulted in shorter hospital stays and lower lymph node metastasis rates.

Abstract

Small thyroid-like carcinoma (PTMC) is one of the most common subtypes of thyroid cancer. The main treatment options include surgery and radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA). Thermal ablation has the advantage of being less invasive and has fewer complications than traditional surgical treatment.

The objective is to explore the efficacy and safety of PTMC by different thermal ablation modalities through a network meta-analysis.

From the database establishment to October 2021, a computerized search of the Chinese Knowledge Infrastructure (CKNI), VIP Chinese Science and Technology Journal Full-Text Database (VP-CSJFD), WanFang Data journal article resource (WangFang), PubMed, the Cochrane Library, and Embase were performed to include the different methods of thermal ablation for small thyroid carcinoma. A retrospective study of different methods of thermal ablation of small thyroid carcinoma was included.

A total of 12 retrospective studies involving 1,926 patients with PTMC were included, all of which were of high quality. This study mainly involved RFA, MWA, LA, and ethanol combined with radiofrequency ablation (EA + RFA). Network meta-analysis showed no significant difference between interventions (p > 0.05) in terms of recurrence rate.

Surgical resection may be the measure with the lowest recurrence rate after treatment of PTMC, LA may be the measure with the lowest incidence of complications after treatment, and RFA may be the measure with the least length of hospital stay, operation time, and postoperative lymph node metastasis rate. However, due to the limitations of network meta-analysis, this result still needs to be treated with caution, and more high-quality, large-sample clinical studies are recommended for further verification.