A comparative study of quality of life in patients with papillary thyroid carcinoma undergoing microwave ablation vs. Total thyroidectomy

Figures & data

Figure 1. Images of a 52-year-old woman with papillary thyroid carcinoma in the right lobe treated with microwave ablation. (A) Ultrasound showed a hypoechoic tumor in the right lobe (white arrows). (B) The hydro dissection technique (blue arrows) was used to keep the thyroid lobe far from the carotid artery, trachea, and nerves to guarantee the safety of ablation. (C) The microwave ablation antenna was precisely inserted into the tumor (blue arrows) and the ablation zone showed a hyperechoic pattern in the tumor around the antenna tip (white arrows). (D) Postablation CE-US image showed no enhancement in the tumor (white arrows).

Figure 2. Patient flowchart. MWA: microwave ablation; PTC: papillary thyroid carcinoma; TT: total thyroidectomy; PSM: propensity score matching.

Table 1. Baseline characteristics.

Parameter	Before PSM		p Value	After PSM		P Value
	MWA (n = 125)	TT (n = 203)		MWA (n = 90)	TT (n = 90)
Sex			0.385			0.729
M	31(24.8)	42(20.7)		21(23.3)	23(25.6)
F	94(75.2)	161(79.3)		69(76.7)	67(74.4)
Age(y)^⬆	44 ± 13	49 ± 14	0.002*	46 ± 13	46 ± 12	0.939
Marriage status			0.000*			0.550
Single	19(15.2)	7(3.4)		7(7.8)	5(5.6)
Marital	106(84.8)	196(96.6)		83(92.2)	85(94.4)
Education level			0.000*			0.318
Primary/below	4(3.2)	20(9.9)		4(4.4)	2(2.2)
Middle/high school	33(26.4)	125(61.6)		31(34.4)	41(45.6)
College	55 (44.0)	44(21.7)		43(47.8)	33(36.7)
College and above	33(26.4)	14(6.9)		12(13.3)	14(15.6)
Family history of thyroid cancer			0.003*			0.839
Yes	28(22.4)	21(10.3)		14(15.6)	15(16.7)
No	97(77.6)	182(89.7)		76(84.4)	75(83.3)
Comorbidity			0.000*			0.697
Yes	18(14.4)	69(34.0)		17(18.9)	15(16.7)
No	107(85.6)	134(66.0)		73(81.1)	75(83.3)
Follow-up time (mo)^⬇	12(3–18)	18(3–36)	0.001*	12.5(3–18)	12.5(3–18)	0.794

Unless otherwise specified, data are numbers of patients, with percentages in parentheses. MWA: microwave ablation; PSM: propensity score matching; TT: total thyroidectomy.

*Statistically significant.

⬆Data are means ± SDs.

⬇Data are medians, with IQRs in parentheses.

Table 2. Comparation of EORTC-QLQ-30 in patients with PTC who underwent MWA vs. those who underwent TT.

	MWA	TT	p-Value
	n = 90	n = 90
EORTC-QLQ-30
Global health +	66.67(50.00–83.33)	66.67(50.00–75.00)	0.033
EORTC-QLQ-30 functioning +
Physical	100.00(93.33–100.00)	93.33(86.67–100.00)	＜0.001
Role	100.00(100.00–100.00)	100.00(100.00–100.00)	0.058
Emotion	95.83(75.00–100.00)	83.33(75.00–100.00)	0.015
Cognitive	100.00(83.33–100.00)	83.33(83.33–100.00)	＜0.001
Social	100.00(100.00–100.00)	100.00(83.33–100.00)	＜0.001
EORTC-QLQ-30 symptoms ++
FATIGUE	11.11(0.00–22.22)	22.22(11.11–33.33)	＜0.001
NAUSEA/VOMITING	0.00(0.00–0.00)	0.00(0.00–0.00)	0.400
PAIN	0.00(0.00–0.00)	0.00(0.00–16.67)	0.004
EORTC-QLQ-30 single-item ++
Dyspnea	0.00(0.00–33.33)	0.00(0.00–33.33)	0.167
Insomnia	0.00(0.00–33.33)	33.33 (0.00–33.33)	0.021
Appetite	0.00(0.00–0.00)	0.00(0.00–0.00)	0.535
Constipation	0.00(0.00–0.00)	0.00(0.00–33.33)	0.048
Diarrhea	0.00(0.00–0.00)	0.00(0.00–0.00)	>0.99
Financial difficulties	0.00(0.00–0.00)	0.00(0.00–33.33)	＜0.001
EORTC-QLQ-30 Summary score	40.21(38.46–42.74)	40.79(38.46–43.53)	0.276

+Higher scores indicate better functioning; ++Higher scores indicate more symptoms.

Data are median scores, with 95% CIs in parentheses.

Table 3. Comparation of THYCA-QoL in patients with PTC who underwent MWA vs. those who underwent TT.

	MWA	TT	p-Value
	n = 90	n = 90
THYCA-QoL scales ++
Neuromuscular	0.00(0.00–11.11)	11.11(11.11–22.22)	＜0.001
Voice	0.00(0.00–4.17)	16.67(0.00–33.33)	＜0.001
Concentration	0.00(0.00–0.00)	0.00(0.00–33.33)	＜0.001
Sympathetic	0.00(0.00–16.67)	16.67(0.00–33.33)	0.007
Throat/mouth	11.11(0.00–11.11)	16.67(11.11–33.33)	＜0.001
Psychological	8.33(0.00–18.75)	16.67(8.33–33.33)	0.001
Sensory	0.00(0.00–33.33)	16.67 (0.00–33.33)	0.024
THYCA-QoL single items ++
Scar	0.00(0.00–0.00)	33.33(0.00–33.33)	＜0.001
Chilly	0.00(0.00–33.33)	33.33(0.00–33.33)	0.033
Tingling hands/feet	0.00(0.00–0.00)	0.00(0.00–8.33)	0.012
Gained weight	0.00(0.00–33.33)	33.33(0.00–33.33)	＜0.001
Headaches	0.00(0.00–33.33)	0.00(0.00–33.33)	0.574
Less interest in sex	0.00(0.00–33.33)	33.33(0.00–33.33)	＜0.001
THYCA-QoL summary score	8.44(3.85–15.01)	16.45(11.00–24.15)	＜0.001

++Higher scores indicate more symptoms; Data are median scores, with 95% CIs in parentheses.

Table 4. Oncological outcome in the MWA group and the TT group.

	MWA(n = 90)	TT(n = 90)	P value
Technical success	90(100)	90(100)	/
Disease progression	3(3.3)	4(4.4)	>0.99
Metastasis free survival	89(98.9)	89(98.9)	>0.99
Overall survival	90(100)	90(100)	/
local tumor control	89(98.9)	90(100)	>0.99

Unless otherwise specified, data are numbers of findings, with percentages in parentheses. MWA: microwave ablation; TT: total thyroidectomy.

Data availability statement

Some or all datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author upon reasonable request.