Thermal field management improves patient-reported outcomes during ablation for papillary thyroid carcinoma: A retrospective cohort study

Abstract

BACKGROUND

Thermal ablation (TA) has been proved to be effective and safe as minimally invasive treatment method for thyroid nodules. However, patients' experience during the procedures and quality of life varies among operators.

AIM

To explore strategy to improve quality of life and subjective experiences during TA for papillary thyroid carcinoma (PTC) based on thermal field management (TFM).

METHODS

This retrospective propensity-matched cohort study was conducted in a single center. A total of 490 patients with PTC treated with TA from September 2023 to August 2024 were studied and divided into two groups (TFM group and non-TFM group) according to treatment strategies. Propensity score matching (PSM) was used to control for confounding factors. Complications, side effect and complaints of patients were compared between the two groups.

RESULTS

A total of 113 patients (41.7 ± 10.6; 31 men, 82 women) were assigned to the TFM group, and 377 patients (mean age, 41.1 ± 10.7 year; 116 men, 261 women) were assigned to the non-TFM group. After PSM, a total of 108 patients were included in the TFM group, and 216 patients were included in the non-TFM group. The median follow-up was 10 months (range from 4-15 months). The incidence of voice change in the TFM group was significantly lower than that in the non-TFM group (0.9% vs 6.5%; P = 0.049). Although there was no statistically significant difference in rate of pain between the two groups, the proportion of complaining of pain in the TFM group was numerically lower than that in the non-TFM group (3.7% vs 9.7%, P = 0.090).

CONCLUSION

TFM, as a novel procedural optimization technique, can effectively improve quality of life and subjective experiences of patients during TA for PTC.

Keywords: Thermal management; Thermal ablation; Thyroid cancer; Patient-reported outcomes; Papillary thyroid carcinoma

Core Tip: In this study, we introduce the concept of thermal field management (TFM) for the first time as a means to optimize clinical practice in thermal ablation of papillary thyroid carcinoma. This approach does not rely on advanced technical maneuvers but represents a conceptual shift toward more precise, patient-centered ablation. Our results indicate that the TFM strategy effectively enhances quality of life and patient-reported outcomes by reducing specific complications and symptoms.