Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma

Abstract

AIM To compare the effect and postoperative trauma of ultrasound-guided percutaneous microwave ablation and surgical resection in the treatment of papillary thyroid microcarcinoma (PTMC). METHODS Eighty-seven patients with PTMC treated at Fudan University affiliated Shanghai Fifth People’s Hospital were enrolled as subjects. The patients were divided into a microwave ablation group (41 cases) and a surgical group (46 cases). The operative time, intraoperative blood loss, length of hospital stay, serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), thyroid-related hormonal changes, and complications 7 d and 30 d after surgery were observed. RESULTS The operative time, intraoperative blood loss, and length of hospital stay in the surgical group were significantly higher than those in the microwave ablation group ( P < 0.05). The levels of CRP, IL-6, and TNF-α in the surgical group were significantly higher than those in the microwave ablation group ( P < 0.05). The free triiodothyronine (FT3) and free thyroxin (FT4) levels in the surgical group were significantly lower than those in the microwave ablation group ( P < 0.05). However, the postoperative thyroid stimulating hormone (TSH) level was significantly higher than that in the microwave ablation group ( P < 0.05). There were significant interactions between the FT3, FT4, and TSH 7 d and 30 d after operation and the treatment methods ( P < 0.05). There was no significant difference in the complications between the two groups ( P > 0.05). CONCLUSION Microwave ablation for papillary microcarcinoma of the thyroid gland has less trauma to the body, quicker recovery, and no scars. It can effectively shorten the length of hospital stay and improve the quality of life of patients.

Ultrasound-guided laser ablation versus surgery for solitary papillary thyroid microcarcinoma: a retrospective study

“…In our LA group, hypocalcemia did not occur, and, to the best of our knowledge, it has not been reported in the PTMC cases treated by RFA and MWA [11,12]. However, transient hoarseness has been reported after MWA and RFA [12,33]. It did not develop in our LA group.…”

Percutaneous microwave ablation versus surgical resection for ovarian cancer liver metastasis

“…The MWA group had similar preoperative ALT and AST levels but lower immediately postoperative ALT levels compared with the SR group. A large amount of evidence supports the concept that the risk of LTP and OS after MWA or SR are driven by unmodifiable patient-and tumor-related factors [23][24][25][26][27]. The size and number of LM lesions may increase the difficulty of operation and fail to enlarge the safety margin, resulting in poor tumor control.…”

The Efficacy and The Safety of Ultrasound-guided Ablation Therapy for Treating Papillary Thyroid Microcarcinoma

“…In addition, no residue was identified among six MWA studies. Three articles investigated MWA procedure comparing with surgery and reported that MWA, as a minimally invasive treatment of PTMC, embraced lower incidence rate of complications and without decreasing the therapeutic effect 6, 42, 45. The hospital stay, surgery/procedure time is significantly shorter in MWA group than surgery group (Table 5).…”

“…Considering the indolent feature of PTMC, treatments' efficacy, safety and even medical economy should be taken into consideration. As to surgical procedure, high patients' costs and long hospital stay were unavoidable and, in some case, patients' post-operative life quality will be even worse than pre-operation if related complication happens 6. As to AS, some patients' progressing anxiety and heavily psychological burden, because of the tumor diagnosis and the probability of progression, could lead to decreasing life quality even if doctor had interpreted the benign-like feature of this disease.…”