Abstract

Objective

To compare the clinical outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of primary hyperparathyroidism (pHPT).

Method

This retrospective study included 104 pHPT patients treated by MWA or RFA between January 2015 and March 2020 in four centers. The clinical outcomes including effectiveness and complications were compared between the two groups. Ablation cure was defined as the reestablishment of normal values of serum calcium and intact parathyroid hormone (iPTH) at least more than 6 months. Clinical cure was defined as the reestablishment of normal values of serum calcium and iPTH throughout the entire follow-up period.

Results

A total of 77 patients underwent MWA (mean age, 55.5 ± 16.4 years) and 27 underwent RFA (mean age, 58.9 ± 15.6 years). During the follow-up (median, 18.7 months in the MWA group; 12 months in the RFA group), no difference was observed between ablation cure rates (88.3% vs. 88.9%, p = 1.000), clinical cure rates (87.0% vs. 82.3%, p = .880), recurrent pHPT (5.2% vs. 3.7%, p = .447), persistent pHPT (11.7% vs. 11.1%, p = 1.000) and complication rate (9.1% vs. 3.7%, p = .677). A maximum diameter less than 0.7 cm was an independent prognostic factor of uncured pHPT in ablation (hazard ratio, 0.1; 95% confidence interval: 0.02, 0.54; p = .007). Major complication – voice change encountered in five patients (6.5%) in the MWA group and in one patient (3.7%) in the RFA group.

Conclusion

Both RFA and MWA are safe and effective techniques for patients with pHPT, with comparable clinical outcomes.

中文翻译：

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微波消融与射频消融治疗原发性甲状旁腺功能亢进：一项多中心回顾性研究

摘要

客观的

比较微波消融（MWA）和射频消融（RFA）治疗原发性甲状旁腺功能亢进症（pHPT）的临床疗效。

方法

这项回顾性研究包括 2015 年 1 月至 2020 年 3 月在四个中心接受 MWA 或 RFA 治疗的 104 名 pHPT 患者。比较两组的临床结果，包括有效性和并发症。消融治愈定义为血清钙和完整甲状旁腺激素 (iPTH) 恢复正常值至少超过 6 个月。临床治愈定义为在整个随访期间血清钙和 iPTH 恢复正常值。

结果

共有 77 名患者接受了 MWA（平均年龄，55.5 ± 16.4 岁）和 27 名患者接受了 RFA（平均年龄，58.9 ± 15.6 岁）。在随访期间（中位数，MWA 组为 18.7 个月；RFA 组为 12 个月），在消融治愈率（88.3% 对 88.9%，p  = 1.000）和临床治愈率（87.0%）之间没有观察到差异vs. 82.3%, p  = .880)、复发性 pHPT (5.2% vs. 3.7%, p  = .447)、持续性 pHPT (11.7% vs. 11.1%, p  = 1.000) 和并发症发生率 (9.1% vs. 3.7) %，p  = .677）。最大直径小于 0.7 cm 是消融中未治愈 pHPT 的独立预后因素（风险比，0.1；95% 置信区间：0.02, 0.54；p = .007）。主要并发症——MWA 组 5 名患者 (6.5%) 和 RFA 组 1 名患者 (3.7%) 出现声音变化。

结论

RFA 和 MWA 都是对 pHPT 患者安全有效的技术，具有可比的临床结果。