Comparison of health-related quality of life between radiofrequency ablation and surgery for unifocal T1N0M0 papillary thyroid carcinoma : A 5-year follow-up study

Background: Limited information is available on impact of radiofrequency ablation (RFA) and surgery resection (SR) on the quality of life (QoL) of patients with unifocal T1N0M0 PTC. Purpose: This study is to compare the QoL of RFA and SR for unifocal T1N0M0 PTC. Methods: This retrospective study was conducted in a single center. A retrospective data analysis was conducted on patients treated with RFA or SR for T1N0M0 PTC between August 2019 and March 2024. Propensity score matching (PSM) was employed to create comparable groups. The primary outcomes were the disease progression (pathologically confirmed local tumor progression, new tumors or LNM, distant metastasis identified using CT, and PTC-related mortality) and QOL. Secondary outcomes included changes in ablation zone size, and complication rates. The 36-item short form health survey (SF-36) and Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QoL) were completed by patients to evaluate their QoL scores. Results: A total of 265 patients underwent RFA, and 325 underwent surgery. After propensity score matching, 300 patients were ultimately included, with 150 in each group. The technical success rate was 100% for both groups. According to the SF-36 , PTC patients in Mainland China experienced impaired general QoL. In the two years following treatment, the QoL scores for the RFA and SR groups reached a level similar to that of the reference population. These improvements persisted 5 years post-operation. THYCA-QoL showed that the “problems with scarring” and “psychological” scale scores of patients in the RFA group were lower than in the SR group. The RFA group had a less blood loss, shorter operation time, shorter postoperative hospitalization time, and a smaller incision length (all P < 0.001). No major complications occurred in the RFA groups. Conclusion: Our study suggests that RFA provides better cosmetic, and HRQoL outcomes for T1N0M0 PTC patients.