Thermal Ablation for Papillary Thyroid Microcarcinoma: Promise, Pitfalls, and Perspective
Cette étude fait le point sur l'utilisation de la thermoablation pour un microcarcinome papillaire indolent de la thyroïde
Overdiagnosis and overtreatment of indolent, subcentimeter papillary thyroid microcarcinomas (PTMCs) have led to a deliberate shift toward de-escalation of care in recent decades. This movement—marked by reduced screening and diagnosis, less extensive surgery, and the promotion of active surveillance (AS) for select patients—aims to minimize harm without compromising outcomes. Although AS has proven to be a safe alternative to thyroidectomy, patient anxiety about disease progression remains the greatest barrier to its widespread adoption in the US.Recently, ultrasound-guided thermal ablation techniques—radiofrequency ablation, microwave ablation, and laser ablation—have emerged as potential middle-ground options between surgery and observation. These minimally invasive procedures deliver focused treatment directly to the tumor while preserving surrounding thyroid tissue and function, avoiding general anesthesia, and minimizing recovery time. Early studies report that thermal ablation can be performed safely, with low rates of complications and recurrence, for up to 8 years of follow-up.
JAMA Surgery , résumé, 2026