MICROWAVE ABLATION (MWA) delivered comparable long-term cancer outcomes to surgical resection (SR) in selected patients with papillary thyroid cancer, according to a 10-year retrospective analysis. The findings suggested the minimally invasive technique could be considered an additional treatment option alongside surgery for carefully selected patients with unifocal T1aN0M0 papillary thyroid carcinoma (PTC).
PTC is the most common form of thyroid cancer. In this study, researchers evaluated whether ultrasound-guided MWA could provide durable disease control and a favourable safety profile compared with SR, the standard treatment approach.
The single-centre retrospective analysis included 134 patients with unifocal T1aN0M0 papillary thyroid carcinoma who underwent either ultrasound-guided MWA or SR between June and October 2014. The cohort had a mean age of 43.53 years, and 99 participants were female. Patients completed 120 months of follow-up.
The primary endpoints were local tumour recurrence, new tumour development, distant metastasis and lymph node metastasis. Secondary endpoints assessed the volume reduction rate of the ablation zone and procedure-related complications.
After 10 years of follow-up, investigators found no statistically significant difference in disease progression-free survival between patients treated with MWA and those who underwent SR.
Although the overall complication rate was numerically lower in the MWA group, the difference was not reported as statistically significant. Most complications in both treatment groups were transient.
Notably, permanent procedure-related complications occurred only among patients who underwent SR. Preservation of normal thyroid function without the need for thyroid hormone replacement therapy distinguished the MWA group during long-term follow-up, providing additional information alongside the oncological outcomes.
Potential Role in Selected Patients
The investigators concluded that ultrasound-guided MWA could be considered a safe and effective treatment option in addition to SR for selected patients with unifocal T1aN0M0 papillary thyroid carcinoma.
However, they noted that further research was needed to validate these findings. While the results supported MWA as a less invasive management approach for selected patients, the evidence came from a single-centre retrospective study, and further investigation is warranted to validate these results.
Reference
Wang Z-Q et al. Microwave ablation versus surgical resection for unifocal T1aN0M0 papillary thyroid carcinoma: a 10-year follow-up study. Eur Radiol. 2026;DOI:10.1007/s00330-026-12724-z.
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