Ultrasonography-Guided Thermal Ablation for Cervical Lymph Node Metastasis of Recurrent Papillary Thyroid Carcinoma: Is it Superior to Surgical Resection?

作者：Xu Zhang, Tu Ni, Wenzhi Zhang · 发表于：Frontiers in Endocrinology · 年份：2022 · DOI：10.3389/fendo.2022.907195 · 被引用次数：21 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Management of metastatic bone disease

Aim The study aimed to systematically evaluate the safety and efficacy of ultrasonography-guided percutaneous thermal ablation in the treatment of cervical lymph node metastasis (LNM) of recurrent papillary thyroid carcinoma (PTC). Methods PubMed, PubMed Central (PMC), Embase, and Cochrane were examined. The inclusion and exclusion criteria were determined and the relevant data were extracted from the library and other databases for LNM thermal ablation of recurrent PTC. The data were analyzed using Stata15.1, Revman5.3 software, and the standard errors of 95% confidence intervals were estimated using fixed or random effects models. Volume reduction rate (VRR), Serum thyroglobulin (Tg) level before and after thermal ablation, the total complications and major complications incidence were analyzed. Results A total of 18 literature articles were included, namely, 10 radiofrequency ablation (RFA), 4 laser ablation (LA), and 4 microwave ablation (MWA). A total of 321 patients had 498 LNM. LNM volume changes before and at the last follow-up of thermal ablation (SMD = 1.04, I 2 = 8%, 95% CI 0.86–1.21, P <0.0001). The postoperative lymph node VRR was 88.4% (95% CI 77.8–97.3%, I 2 = 34%, P = 0.14). Tg measurements before and after thermal ablation (SMD = 1.15, 95% CI 0.69–1.60, I 2 = 84%, P <0.0001). The incidence of total complications was 5.0% (95% CI 3.0–7.0%, I 2 = 0.0%, P = 0.915), and the incidence of major complications was 4.0% (95% CI 2.0–6.0%, I 2 = 0.0%, P = ...