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      Latest evidence of microwave ablation for papillary thyroid microcarcinoma compared with surgery: A systematic review and meta-analysis

      systematic-review
      Author(s): 1 , , 2 , 1
      Publication date (Electronic):
      Journal: Frontiers in Oncology
      Publisher: Frontiers Media S.A.
      Keywords: microwave ablation, papillary, thyroid, microcarcinoma, PTC

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          Abstract

          Background

          The most typical thyroid gland malignant lesion is papillary thyroid cancer (PTC). In many nations, the prevalence of thyroid cancer (TC) is rising, particularly papillary thyroid microcarcinoma (PTMC). Microwave ablation (MWA) has been gradually carried out in some patients with benign thyroid nodules, some low-risk PTMC, and metastatic lymph nodes in the neck. The role and safety of MWA remain controversial topics. So we conducted this study to provide the latest evidence of MWA for PTMC compared with surgery.

          Methods

          Patients’ postoperative outcomes (duration of hospital stay and hospitalization expenditures), intraoperative outcomes (surgery time, blood loss, and incision size), and follow-up outcomes were all examined (complication rate, recurrence rate, and lymph node metastasis). The effectiveness and safety of MWA versus surgery for PTMC patients were compared using the weighted mean difference (WMD) and odds ratio (OR).

          Results

          In total, we included 7 articles (7 trial comparisons) which contained 1, 567 PTMC patients. The results showed that MWA had significant advantages in operative time (WMD = -53.47, 95% CI: -67.62 to -39.32), postoperative hospital stay (WMD =-4.59, 95% CI: -6.40 to -2.77), hospitalization costs (WMD= -70.06, 95% CI: -90.93 to -49.19), blood loss (WMD =-28.07, 95% CI: -33.77 to -22.38), incisions size (WMD =-59.69, 95% CI: -67.79 to -51.59), and complication rates (OR = 0.28; 95% CI: 0.18 to 0.42) compared with surgery. It also showed that recurrence rates and risk of lymph node metastasis are similar to surgery.

          Conclusions

          For PTMC patients, MWA could be an efficient, safe, and affordable therapy.

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          Most cited references33

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          RoB 2: a revised tool for assessing risk of bias in randomised trials

          Jonathan A C Sterne, Jelena Savović, Matthew J L Page … (2022)
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            2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

            Bryan Haugen, Erik Alexander, Keith Bible … (2016)
            Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
            Article 0 comments Cited 2754 times – based on 0 reviews     Review now
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              The Impact of Diagnostic Changes on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Selected High-Resource Countries.

              Salvatore Vaccarella, Luigino Dal Maso, Mathieu Laversanne … (2015)
              Thyroid cancer (TC) incidence is rising in many countries, but the corresponding mortality is constant or declining. Incidence increases appear largely restricted to small papillary TC in young/middle-age individuals. We compared age-specific incidence rates across countries and time periods in order to estimate the fraction of TC possibly attributable to increased surveillance of the thyroid gland (diagnostic changes) following the introduction of neck ultrasonography in the 1980s.
              Article 0 comments Cited 131 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Oncol
                Journal ID (iso-abbrev): Front Oncol
                Journal ID (publisher-id): Front. Oncol.
                Title: Frontiers in Oncology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2234-943X
                Publication date (Electronic): 07 February 2023
                Publication date Collection: 2023
                Volume: 13
                Electronic Location Identifier: 1088265
                Affiliations
                [1] 1 Department of Ultrasound, Xiamen Haicang hospital , Xiamen, China
                [2] 2 Department of Thyroid and Breast Surgery, Xiamen Haicang hospital , Xiamen, China
                Author notes

                Edited by: Xiang Xue, University of New Mexico, United States

                Reviewed by: Xicheng Song, Qingdao University, China; Chang Deng, Chongqing Seventh People’s Hospital, China

                *Correspondence: Jie Feng, fengjie213213@ 123456163.com

                This article was submitted to Cancer Genetics, a section of the journal Frontiers in Oncology

                Article
                DOI: 10.3389/fonc.2023.1088265
                PMC ID: 9941193
                SO-VID: 065d7fb8-37b4-42f7-8414-937535441273
                Copyright © Copyright © 2023 Feng, Jiang and Feng
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 03 November 2022
                Date accepted : 17 January 2023
                Page count
                Figures: 13, Tables: 2, Equations: 0, References: 33, Pages: 10, Words: 3453
                Funding
                This study was supported by Xiamen Haicang hospital.
                Categories
                Subject: Oncology
                Subject: Systematic Review

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: microwave ablation,papillary,thyroid,microcarcinoma,ptc
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: microwave ablation, papillary, thyroid, microcarcinoma, ptc

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