Comparison of thermal ablation and routine surgery for the treatment of papillary thyroid microcarcinoma: a systematic review and Meta-analysis

Figures & data

Table 1. Basic characteristics of each included article.

First author	Year	City^a	Study design	No. of patients (TA/RS)	Mean age (year) (TA/RS)	Mean tumor diameter (mm) (TA/RS)	Type of TA	Type of RS(TL/TT)^c	Complications	Assessment criteria^d	NOS^e
											Patient selection	Comparability	Outcome assessments	Sum of score
Cao	2018	Shanghai	RC^b	19/36	47.37 ± 11.95/47.53 ± 11.87	5.35 ± 1.57/7.70 ± 5.33	MWA	36/0	Voice change	①,②,③	***	**	**	7
Chen	2018	Hangzhou	RC^b	49/40	44.88 ± 11.04/45.78 ± 13.74	10 m or less in maximum diameter	MWA	40/0	Neck pain	①,②,③,⑥	***	**	***	8
Ma	2018	Hangzhou	RC^b	30/35	46.10 ± 8.20/49.97 ± 10.30	10 mm or less in maximum diameter	MWA	35/0	Voice change	③,⑥	***	**	**	7
Li	2018	Beijing	RC^b	46/46	43.63 ± 9.27/49.59 ± 9.00	4.49 ± 1.55/4.29 ± 1.37	MWA	37/9	Voice change	①,②,③,④	***	**	***	8
Li	2019	Beijing	RC^b	168/143	47.36 ± 10.75/49.18 ± 11.41	10 mm or less in maximum diameter	MWA	143/0	Voice change	③,④,⑤(5 years)	***	**	***	8
Zhang	2020	Beijing	RC^b	94/80	45.40 ± 10.80/44.10 ± 9.60	6.14 ± 2.54/6.03 ± 1.53	RFA	58/22	None	①,②,③,④,⑥	***	**	***	8
Zhou	2019	Shanghai	RC^b	36/45	41.50 ± 11.30/41.60 ± 9.60	4.70 ± 1.40/5.00 ± 1.10	LA	45/0	Hyperthyroidism	①,③,④,⑤(1,3 years),⑥	***	**	***	8

N/A: not available.

* represents one score in this area, **represents two scores in this area, and ***represents three scores in this area.

^a All are Chinese cities.

^b Retrospective cohort.

^c TL: Thyroid lobectomy; TT: Total thyroidectomy.

^d ①Postoperative length of stay; ②Cost during the perioperative period; ③Complication rate; ④Recurrence rate; ⑤Recurrence-free survival; ⑥Operation time.

^e Newcastle-Ottawa Scale.

Figure 1. Procedure for the selection process.

Figure 2. Forest plot of the recurrence rate.

Table 2. Summary estimates of the meta-analytic pooled proportions.

	p-value for heterogeneity	I2	SMD or OR and pooled proportions [95% CI]	p-value for statistically significant difference
Recurrence rate	0.98	0%	0.93 [0.38, 2.30]	0.88
Complication rate	0.47	0%	0.24 [0.13, 0.43]	<0.001
Operation time	0.08	61%	−4.49 [−5.15, −3.83]	<0.001
Postoperative length of stay	<0.001	96%	−3.14 [−4.77, −1.51]	<0.001
Cost during the perioperative period	<0.001	97%	−1.69 [−3.18, −0.20]	0.03

Figure 3. Egger’s funnel plot of (a) the complication rate; (b) the postoperative length of stay.

Figure 4. Forest plot the complication rate.

Figure 5. Sensitivity analysis of (a) the operation time; (b) the postoperative length of stay; (c) the cost during the perioperative period.

Figure 6. Forest plot the operation time.

Figure 7. Forest plot the postoperative length of stay.

Figure 8. Forest plot the cost during the perioperative period.

Figure 9. Ultrasound images of MWA in a patient with solitary PTC in our institution. (a) Before MWA therapy; (b) Immediately after MWA therapy; (c) 3 months after MWA therapy; (d) 18 months after MWA therapy.