Radiofrequency Ablation for Low-Risk T1N0M0 Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis.
4 affiliations
- 1Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- 2Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.
- 3Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
- 4Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. [email protected].
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% (I² = 97.9%). The pooled persistent-tumor rate was 0.1% (I² = 57.6%), and the pooled disease-progression rate, which reflected newly developed tumors (0.8%; I² = 63.9%) and lymph node metastasis (0.2%; I² = 19.8%), was 1.3% (I² = 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% (I² = 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.
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BibTeX
@article{lee2026radiofrequency,
title = {{Radiofrequency Ablation for Low-Risk T1N0M0 Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis.}},
author = {Min Kyoung Lee and Eun Ju Ha and Ji Ye Lee and Ji-Hoon Kim},
journal = {Korean journal of radiology},
year = {2026},
month = oct,
doi = {10.3348/kjr.2026.0042},
url = {https://europepmc.org/article/MED/42849890},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Radiofrequency Ablation for Low-Risk T1N0M0 Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis.
AU - Min Kyoung Lee
AU - Eun Ju Ha
AU - Ji Ye Lee
AU - Ji-Hoon Kim
PY - 2026
DA - 2026/10/01
JO - Korean journal of radiology
DO - 10.3348/kjr.2026.0042
UR - https://europepmc.org/article/MED/42849890
AB - 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% (I² = 97.9%). The pooled persistent-tumor rate was 0.1% (I² = 57.6%), and the pooled disease-progression rate, which reflected newly developed tumors (0.8%; I² = 63.9%) and lymph node metastasis (0.2%; I² = 19.8%), was 1.3% (I² = 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% (I² = 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.
SN - 1229-6929
SN - 2005-8330
ER -