Purpose We aimed to compare the efficacy and safety of radiofrequency ablation (RFA) to that of surgical resection (SR) in patients with T1bN0M0 papillary thyroid carcinoma (PTC) in different age groups. Methods Totally, 204 patients with an isolated, solitary, intrathyroidal T1bN0M0 PTC, who underwent either RFA (n=94) or SR (n=110) between April 2014 and December 2019, were retrospectively enrolled and were divided into two subgroups according to age (<45 years, ≧45 years). Patients with pathologically aggressive or advanced lesions were excluded from the study. Tumor progression and procedural complications were the primary and secondary endpoints, respectively. Tumor recurrence in situ, newly discovered tumors, lymph node involvement, or distant metastases indicated tumor progression. Complications included pain, fever, voice change, choking, numbness in the limbs, and cardiac events. Incidence rates of all endpoint events were compared between different age subgroups. Results There were no significant differences in age, sex, and tumor size between the treatment groups. While the RFA group incurred less cost and experienced significantly shorter operative duration than the SR group, no significant differences were observed in incidences of both tumor progression and complications. Further, subgroup analysis of patients <45 years versus those ≧45 years showed no significant differences in the incidence of tumor progression and complications within or between different treatment groups. Older patients in the SR group incurred higher hospital costs than younger counterparts, but this difference was not observed in the RFA group. Conclusions Our results indicated that RFA had a similar prognosis as that of SR but was associated with lower overall cost in both young (<45 years) and middle-aged patients (≧45 years) with T1bN0M0 PTC. Therefore, RFA may be an effective and safe alternative to surgery for the treatment of patients with T1bN0M0 PTC.

中文翻译：

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超声引导射频消融与手术切除治疗不同年龄组 T1bN0M0 甲状腺乳头状癌。

目的我们旨在比较射频消融（RFA）与手术切除（SR）对不同年龄组T1bN0M0甲状腺乳头状癌（PTC）患者的疗效和安全性。方法 回顾性纳入2014年4月至2019年12月接受RFA（n=94）或SR（n=110）的204例孤立性、孤立性甲状腺内T1bN0M0 PTC患者，并根据年龄分为两个亚组（<45 岁，≥45 岁）。具有病理侵袭性或晚期病变的患者被排除在研究之外。肿瘤进展和手术并发症分别是主要和次要终点。原位肿瘤复发、新发现的肿瘤、淋巴结受累或远处转移表明肿瘤进展。并发症包括疼痛、发烧、声音改变、窒息、四肢麻木和心脏事件。比较了不同年龄亚组之间所有终点事件的发生率。结果 治疗组之间的年龄、性别和肿瘤大小没有显着差异。虽然 RFA 组比 SR 组花费更少并且手术时间明显更短，但在肿瘤进展和并发症的发生率方面没有观察到显着差异。此外，<45 岁患者与≥45 岁患者的亚组分析显示，不同治疗组内或不同治疗组之间的肿瘤进展和并发症发生率没有显着差异。SR 组中老年患者的住院费用高于年轻患者，但在 RFA 组中未观察到这种差异。结论 我们的结果表明，RFA 的预后与 SR 相似，但与 T1bN0M0 PTC 的年轻（<45 岁）和中年（≥45 岁）患者的总体成本较低相关。因此，RFA 可能是治疗 T1bN0M0 PTC 患者的一种有效且安全的手术替代方法。