Thermal Ablation Is Effective for Papillary Thyroid Carcinoma

Yan L, Li Y, Li X, et al. Thermal Ablation for Papillary Thyroid Carcinoma. JAMA Otolaryngol Head Neck Surg. 2024;151(1):9-17.

Noel JE, Wrenn SM. Outcomes of Thermal Ablation for Papillary Thyroid Carcinoma. JAMA Otolaryngol Head Neck Surg. 2024; in press.

Yan and coauthors reported 10-year outcomes of patients (n = 179) with T1N0M0 papillary thyroid cancer (PTC) treated with thermal ablation in 4 Chinese academic medical centers. All patients had lesions of 20 mm diameter or less and no evidence of extrathyroidal extension or metastatic disease.

The main outcome of interest was disease progression (defined as new or persistent tumors), distant metastasis, and disease-free survival.

Tumor disappearance rate after treatment was 97.2% (99.4% in T1a and 71.4 in T1b). Disease progression occurred in 6.1% of patients during the follow-up interval.

The authors concluded that thermal ablation was safe and effective.

In the editorial by Noel and Wrenn that accompanied the article, they noted that long-term complete tumor disappearance is not attainable in all patients and the need for surveillance and repeat biopsy in this patient group is a cause for concern. This situation is more often seen in patients with T1b tumors. Although thermal ablation should continue to be a treatment option, additional long-term data will be valuable for clinicians and patients.