Effect and survival prognosis of radiofrequency ablation combined with TSH suppression in the treatment of papillary thyroid microcarcinoma

doi:10.3877/cma.j.issn.1674-3946.2025.02.022.

Abstract

Abstract:

Objective

To investigate the effect and survival prognosis of radiofrequency ablation(RFA) combined with thyroid stimulating hormone (TSH) suppression in the treatment of papillary thyroid microcarcinoma (PTMC).

Methods

The medical records of 148 patients with PTMC in the hospital were retrospectively analyzed from April 2020 to April 2023.According to different treatment methods, they were divided into RFA group (RFA combined with TSH suppression therapy, n=76) and resection group (surgical resection combined with TSH suppression therapy, n=72).The data were analyzed by SPSS 24.0 software.Measurement data such as surgical related indicators, lesion volume and thyroid hormone indicators were expressed as (x±s).LSD-t test was used for between-group comparison, and paired sample t test was adopted for within-group comparison.Enumeration data such as lymph node metastasis rate and tumor recurrence rate were expressed as ［cases (%)］ by adopting χ² test.P＜0.05 was considered statistically significant.

Results

The surgical time, intraoperative blood loss, hospital stay and VSS score in RFA group were shorter or less than those in resection group (P＜0.05).The incidence rates of complications in RFA group were lower than those in resection group (P＜0.05).At 1, 3, 6 and 12 months after surgery, the lesion volume in RFA group showed a decreasing trend, and the VRR showed an increasing trend (P＜0.05).TSH level at 30 days after surgery was increased in RFA group (P＜0.05), and the level was lower in RFA group than that in resection group (P＜0.05).The levels of free triiodothyronine (FT3) and free thyroxine (FT4) at 30 days after surgery were declined in both groups (P＜0.05), but the levels in RFA group were higher than those in resection group (P＜0.05).There was no obvious difference in incidence rate of total poor prognosis between both groups (1.3% vs. 4.2%)(P＞0.05).

Conclusion

RFA combined with TSH suppression therapy and surgical resection can achieve good results, but RFA can better reduce intraoperative blood loss, surgical time and hospital stay, avoid high risk of complications and promote rapid absorption of lesions, and it has better long-term prognosis effect and has more minimally invasive advantages.

Key words: Carcinoma, Papillary, Thyroid Neoplasms, Radiofrequency Ablation, Thyroidectomy, Thyrotropin Suppression, Prognosis

Jiaxu Dong, Meizi Song, Xun Bi. Effect and survival prognosis of radiofrequency ablation combined with TSH suppression in the treatment of papillary thyroid microcarcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(02): 200-203.

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URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2025.02.022.

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Figures/Tables 4

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ±s）	结节最大径（mm， $\overset{ˉ}{x}$ ±s）	结节形态（例）
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	结节最大径（mm， $\overset{ˉ}{x}$ ±s）	纵横比＞1/纵横比＜1
RFA组	76	40/36	47.3±8.5	4.9±1.3	45/31
切除组	72	37/35	47.7±8.7	4.7±1.2	39/33
χ ²/t/Z值		0.023	0.240	0.862	0.383
P值		0.880	0.810	0.390	0.536

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ±s）	结节最大径（mm， $\overset{ˉ}{x}$ ±s）	结节形态（例）
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	结节最大径（mm， $\overset{ˉ}{x}$ ±s）	纵横比＞1/纵横比＜1
RFA组	76	40/36	47.3±8.5	4.9±1.3	45/31
切除组	72	37/35	47.7±8.7	4.7±1.2	39/33
χ ²/t/Z值		0.023	0.240	0.862	0.383
P值		0.880	0.810	0.390	0.536

组别	例数	手术时间（min）	术中出血量（ml）	住院时间（d）	VSS评分（分）
RFA组	76	24.41±4.25	6.20±1.43	1.76±0.30	4.21±0.57
切除组	72	50.26±8.53	23.53±3.26	3.03±1.17	7.19±1.29
t值		23.520	15.563	9.152	16.710
P值		＜0.001	＜0.001	＜0.001	＜0.001

	病灶体积（mm³）	VRR(%)
消融前	148.23±11.12	-
术后1个月	116.76±10.74	21.23±3.40
术后3个月	69.92±10.31^a	52.83±7.32^a
术后6个月	23.23±9.95^ab	84.33±10.48^ab
术后12个月	14.41±9.04^abc	90.28±18.74^abc

组别	例数	时间	TSH(mIU/L)	FT3(pmol/L)	FT4(μmol/L)
RFA组	76	术前	2.18±0.37	4.21±1.29	12.94±2.35
RFA组	76	术后30d	1.95±0.46^ab	3.85±0.66^ab	11.60±2.22^ab
切除组	72	术前	2.12±0.35	4.09±1.32	12.57±2.70
切除组	72	术后30d	2.29±0.73	2.38±0.39^a	9.55±1.46^a

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