Work

Radiofrequency Ablation for Low-Risk T1N0M0 Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Objective: To evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for low-risk T1N0M0 papillary thyroid carcinoma (PTC), with emphasis on T1a versus T1b outcomes and longitudinal volume regression.Materials and Methods: MEDLINE, EMBASE, Cochrane Library, and KoreaMed databases were searched for studies published between January 2000 and March 2025.Both single-arm and comparative studies were eligible when RFA outcome data could be extracted independently.Thirty-five studies (9,787 tumors) were included in the analysis.Pooled estimates for complete disappearance, persistent tumors, disease progression, and complication rates were calculated using random-effects models.The volume-reduction ratio (VRR) was assessed at sequential follow-up intervals.Subgroup analyses were used to compare the outcomes for T1a and T1b PTCs.Results: Among the 9,787 RFA-treated tumors, the pooled complete disappearance rate was 87.2% (I 2 = 97.9%).The pooled persistent-tumor rate was 0.1% (I 2 = 57.6%),and the pooled disease-progression rate, which reflected newly developed tumors (0.8%; I 2 = 63.9%) and lymph node metastasis (0.2%; I 2 = 19.8%),was 1.3% (I 2 = 70.0%).The VRR increased from 63.4% at 6 months to 88.7% at 12 months and reached 97.9% at 24 months.The pooled complication rate was 2.7% (I 2 = 93.0%),and the major complication rate was 0.02% (I² = 0%).Subgroup analyses showed lower complete disappearance rates (89.2% vs. 58.8%;P < 0.001) and higher persistent-tumor rates (0.02% vs. 2.2%; P < 0.001) in T1b tumors than in T1a tumors; disease progression (P = 0.234) and total complication rates (P = 0.794) were comparable.Conclusion: US-guided RFA may provide effective tumor control with favorable safety in low-risk T1N0M0 PTC.However, heterogeneity across several efficacy outcomes limits the interpretability of these estimates.T1b PTCs showed lower complete disappearance and higher persistent-tumor rates than T1a PTCs, supporting the need for heightened surveillance of T1b disease.

Source: Korean Journal of Radiology

DOI: 10.3348/kjr.2026.0042

Authors: Min Kyoung Lee, Eun Ju Ha, Ji Ye Lee, Ji-hoon Kim

Institutions: The Catholic University of Korea Yeouido St. Mary's Hospital, Catholic University of Korea, Ajou University, Seoul National University, Seoul National University Hospital

Language: English

Topic: Thyroid Cancer Diagnosis and Treatment

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W7212451692