MICROWAVE ablation offers a potential alternative to invasive surgery for patients with the most common type of thyroid cancer, papillary thyroid carcinoma (PTC). Individuals with PTC often present with two or more nodules in their thyroid gland, with between 23.5–60.0% of cases showing this multifocality.
Multifocal PTC is commonly treated with surgical resection, which involves the removal of all, or some of, the thyroid. This method, however, can cause scarring; can lead to the need for lifelong hormone replacement; and can cause potential complications, such as permanent hoarseness or impaired thyroid function, all of which impact a patient’s quality of life. New research suggests that microwave ablation may offer a minimally invasive alternative to surgical resection.
Researchers investigated 775 patients with ultrasound-detected multifocal Stage I PTC, treated with either microwave ablation or surgery, across 10 centres, between May 2015–December 2021. After propensity score matching was performed to reduce bias, 229 patients in the microwave ablation group, and 453 patients in the surgical resection group, were followed for a median of 20 months and 26 months, respectively.
The team found that microwave ablation had similar progression-free survival rates to surgery (5-year: 77.2% versus 83.1%); however, it showed fewer complications, and a greater potential for preserving thyroid function. Microwave ablation also resulted in reduced blood loss, shorter incision length, shorter procedure durations, and shorter hospital stays. Permanent hoarseness (2.2%) and hypoparathyroidism (4.0%) were encountered only in the surgical resection group.
These results demonstrate the potential for a minimally invasive treatment method for PTC, which can significantly improve patient quality of life compared to surgery. One of the authors of the study, Ming-An Yu, China-Japan Friendship Hospital, Beijing, China, commented: “This represents a significant advancement in the field of interventional thyroid cancer treatment,” adding, however, that microwave ablation does not routinely include preventative ablation of lymph nodes, which is common practice in surgical resection. The research team emphasised that microwave ablation yielded comparable survival rates to surgical resection, even without lymph node ablation.
