Thermal Ablation for Papillary Thyroid Carcinoma Is Examined in Article Series

Yan L, Li Y, Li X, et al. Thermal Ablation for Papillary Thyroid Carcinoma. JAMA Otolaryngology Head Neck Surg. 2024; in press.

Noel JE, Wrenn SM. Outcomes of Thermal Ablation for Papillary Thyroid Carcinoma. JAMA Otolaryngology Head Neck Surg. 2024; in press.

Jiang M, Yu Y, Yang A. Concerns Regarding Thermal Ablation for Papillary Thyroid Cancer. JAMA Surg. 2024;159(11):1231-1232.

Yan and coauthors reported a multi-institutional cohort study, conducted in Chinese healthcare facilities, that provided 10-year outcomes data on 179 patients with T1N0M0 papillary thyroid cancers treated with thermal ablation. The main outcomes of interest were disease progression and disease-free survival.

The data analysis showed that disease progression occurred in 6.1% of patients (lymph node metastasis in 2.2%, new tumors in 3.3%, and persistent tumor in 0.6%). The authors emphasized that tumor disappearance rates were significantly lower in patients with T1B tumors compared with T1A tumors.

They concluded that their data suggest that thermal ablation is an effective treatment, especially for smaller tumors and recommended careful surveillance by experienced specialists.

The editorial by Noel and Wrenn emphasized that outcomes for thermal ablation and active surveillance are similar, especially for smaller tumors. They recommended that patient-centered counselling be used to determine which of the various effective treatments (thyroidectomy, active surveillance, radioactive iodine, or thermal ablation) is chosen for management of low-risk papillary thyroid cancer.

The viewpoint article by Jiang and coauthors noted the lack of long-term follow up in patients receiving thermal ablation. This deficiency is at least partially addressed by the data reported in the article by Yan and coauthors.