Ultrasound-Guided Microwave Ablation Vs. Surgery for Low-Risk PapilaryThyroid Carcinoma

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• The inclusion criteria of this study were as followed:
• PTC confirmed by fine-needle aspiration (FNA);
• Confirmed low-risk mutation types by next-generation sequencing (NGS) before surgery;
• No severe functional diseases, such as heart failure, severe respiratory diseases, or renal failure;
• Availability of complete follow-up data.
  • The exclusion criteria were as followed:
• No local or distant metastasis assessed by imaging evaluations, including ultrasound or computed tomography (CT);
• Lacking of preoperative genetic testing or inability to assess genetic test results;
• Inability to complete follow-up or lost to follow-up during the study.
  • Low-risk PTC is defined as:
• Maximum tumor diameter ≤1 cm;
• Solitary lesion;
• No local or distant metastasis;
• No tumor invasion into extrathyroidal tissues;
• No vascular invasion;
• Non-invasive pathological subtype for the primary lesion (invasive subtypes include tall cell, columnar cell, diffuse sclerosing, solid/trabecular, and oncocytic vari ants);
• No history of head and neck radiotherapy during adolescence;
• No family history of thyroid cancer;
• Genetic testing showing BRAF V600E mutation (without concurrent TERT mutation), RAS family gene mutations, (HRAS, NRAS, KRAS), or other low-risk mutations, such as isolated RET/PTC) rearrangements.
  • Intermediate-high risk PTC is defined as:
• Maximum tumor diameter >1 cm;
• Multifocal thyroid cancer;
• Local or distant metastasis;
• Primary lesion with extrathyroidal extension;
• Vascular invasion;
• Primary lesion with an invasive pathological subtype;
• History of head and neck radiotherapy during adolescence;
• Family history of thyroid cancer;
• Genetic testing revealing high-risk mutation combinations, such as BRAF V600E or RAS mutations with concurrent TERT or TP53 mutations, or RAS mutations combined with EIF1AX mutations.