Background. The incidence of papillary thyroid microcarcinoma (PTMC) has significantly increased in recent years, and the decision to use radioactive iodine (RAI) ablation in low-risk (LR) and intermediate-risk (IR) patients is controversial. The aim of this study was to evaluate whether RAI ablation can reduce the recurrence rate in LR-IR PTMC patients. Methods. A comprehensive literature search of the PubMed, Embase, Cochrane Library, and Web of Science was conducted according to the PRISMA statement. Results. There were 8 studies in English that fit our search strategy, and a total of 2847 patients were evaluated. The results of the meta-analysis showed RAI ablation in LR-IR PTMC patients did not reduce cancer recurrence (risk radio (RR) 0.56, 95% CI 0.19-1.70, ). Nevertheless, we further performed data analysis and found that IR PTMC patients without RAI ablation had a higher rate of cancer recurrence than those who underwent RAI ablation (RR 0.23, 95% CI 0.11-0.49, ). Furthermore, patients with risk factors for lymph node metastasis (RR 0.16, 95% CI 0.06-0.42, ), microscopic extrathyroidal extension (RR 0.19, 95% CI 0.06-0.60, ), and multifocality (RR 0.13, 95% CI 0.04-0.45, ) in the absence of RAI ablation were more likely to have recurrence. Conclusions. Based on our current evidence, RAI ablation can reduce the cancer recurrence rate over 5 years in IR PTMC patients, especially when patients have some risk factors, such as lymph node metastasis, microscopic extrathyroidal extension, and multifocality.

中文翻译：

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放射性碘消融可以降低中危乳头状甲状腺微小癌的结构性复发率：一项荟萃分析

背景。近年来，甲状腺微小乳头状癌 (PTMC) 的发病率显着增加，在低危 (LR) 和中危 (IR) 患者中使用放射性碘 (RAI) 消融的决定存在争议。本研究的目的是评估 RAI 消融是否可以降低 LR-IR PTMC 患者的复发率。方法。根据 PRISMA 声明，对 PubMed、Embase、Cochrane 图书馆和 Web of Science 进行了全面的文献检索。结果。有 8 项英文研究符合我们的搜索策略，共评估了 2847 名患者。荟萃分析的结果显示，LR-IR PTMC 患者的 RAI 消融并未减少癌症复发（风险无线电 (RR) 0.56，95% CI 0.19-1.70，）。尽管如此，我们进一步进行了数据分析，发现未接受 RAI 消融的 IR PTMC 患者的癌症复发率高于接受 RAI 消融的患者（RR 0.23，95% CI 0.11-0.49，）。此外，有淋巴结转移危险因素的患者（RR 0.16, 95% CI 0.06-0.42,),显微镜下甲状腺外扩张 (RR 0.19, 95% CI 0.06-0.60,)和多焦点性 (RR 0.13, 95% CI 0.04-0.45,)在没有 RAI 消融的情况下更有可能复发。结论。根据我们目前的证据，RAI 消融可以降低 IR PTMC 患者 5 年以上的癌症复发率，尤其是当患者有一些危险因素时，例如淋巴结转移、显微镜下甲状腺外延伸和多灶性。