微波消融治疗多灶性T1aN0M0期甲状腺乳头状癌的安全性及有效性评价研究OA

Objective:To explore efficacy and safety of microwave ablation(MWA)in treating multifocal papillary thyroid carcinoma(PTC)at T1aN0M0 stage.Methods:The clinical data of 45 patients with 93 PTCs who underwent microwave ablation from January 2015 to June 2021 were retrospectively collected.Among of them,5 patients(11.1%)were male,and 40 patients(88.9%)were female,and the mean age was 45.76±9.95 years old.The median duration of follow-up period was 18 months(range 6-76 months).The success rate,and postoperative volume reduction rate(VRR)of ablation area of MWA were recorded in treating multifocal PTC at T1aN0M0 stage.Tumor progression and complications were monitored,and the risk factors of postoperative progression was analyzed.Results:The success rate of MWA technique was 100%.At the 1st month,the maximum diameter(MD)value[0.80(0.40,1.30)cm]and mean volume(MV)value[0.22(0.04,0.52)cm3]of ablation area were larger than MD value[0.40(0.30,0.50)cm]and MV value[0.02(0.01,0.04)cm3]of initial tumor,and the differences of them were statistically significant(z=-4.933,-5.514,P<0.05).At the 12th month,the MD value[0.0(0.0,0.4)cm]and MV value[0.00(0.00,0.02)cm3]of ablation area were significantly smaller than those of initial tumor(z=-5.533,-5.336,P<0.05).At the end of follow-up,the ablation area of 46 cases completely disappeared(46/93,49.5%).New tumor development occurred in 2 patients(2/45,4.4%).The lymph node metastasis or distant metastasis did not occur in any patient.There was no correlation between disease progression and age,gender,whether combined with chronic lymphocytic thyroiditis(CLT),as well as the number and distribution of case,and the size of the primary tumor.In our study,only one patient occurred hoarse voice(1/45,2.2%),which was self-alleviation with oral mecobalamin after 1 month.Conclusion:MWA could obtain favorable clinically curative effect in treating multifocal PTC at T1aN0M0.