Early Outcomes of Thermal Ablation for Low-Risk Papillary Thyroid Cancer: A Multicenter Study from Latin American Interventional Thyroidology Association (LAITA)
Juan Pablo Dueñas, Nathalia Buitrago-Gómez, Antonio Rahal, Jose Higinio Steck, Gustavo Philippi de los Santos, Cristhian García, Emerson Favero, Rafael De Cicco, Leonardo G. Rangel, Richard Godoy, Eleonora Horvath, Juan Pablo Niedmann Espinosa, Ana Voogd, Lorena Savluk, Erick Gonzales, Antonio Augusto Tupinambá Bertelli, Camilo González-Velazquez, Leonardo de Moura Volpi, Erivelto Martinho VolpiBackground:
Thermal ablation has emerged as a minimally invasive alternative for low-risk papillary thyroid cancer (PTC). However, data from Latin America remain scarce. This multicenter study evaluated the early efficacy and safety of thermal ablation for low-risk PTC across multiple Latin American centers.
Methods:
Retrospective cohort study including 251 patients with 252 tumors (T1N0M0 PTC, ≤2 cm) treated with ultrasound-guided radiofrequency ablation (RFA) at 12 centers across 6 Latin American countries from January 2019 to June 2025. Primary outcomes were complete tumor disappearance, disease progression, and complications.
Results:
Median age was 45.5 years (interquartile range [IQR]: 36.5–56), with 74.2% female patients. Median tumor size was 6.7 mm (IQR: 5–8); 92.1% were T1a (≤10 mm). After a median follow-up of 18 months (IQR 12–24, range 12–72), complete tumor disappearance was achieved in 89.7% overall (226/252), reaching 97.0% in tumors with ≥18 months and 100% with ≥36 months of follow-up. Tumor persistence was observed in 10.3% (26/252) at last follow-up, with no lymph node or distant metastases. The overall complication rate was 2.4% (6/252), all consisting of transient dysphonia. On multivariable analysis, tumor size >10 mm was independently associated with a lower likelihood of complete tumor disappearance (adjusted odds ratios [OR] 0.23 [CI: 0.07–0.78]), whereas follow-up >12 months was associated with a higher likelihood (adjusted OR: 11.33 [CI: 3.61–35.6]). A supplementary
Conclusions:
RFA demonstrates excellent efficacy and acceptable safety for T1a low-risk PTC in Latin American patients, with outcomes comparable with other series, supporting it as a viable alternative to surgery or active surveillance in selected patients. Efficacy for T1b tumors was lower and based on a small number of cases; ablation of T1b disease should therefore be regarded as requiring further investigation, ideally within the framework of a clinical trial.