SAT-338 A Less Invasive Path to Better Quality of Life? A Meta-analysis of Radiofrequency Ablation vs. Thyroidectomy for Papillary Thyroid Carcinoma

Abstract Disclosure: M. Panchana-Lascano: None. G. Minchalo-Ochoa: None. T. Leone-Berry: None. R. Kronfle Cordovez: None. C. Vela Velásquez: None. S. Balda Cañizares: None. I. Diaz-Djevoich: None. F. Veintemilla-Burgos: None. Background: Papillary thyroid carcinoma (PTC) accounts for 85% of newly diagnosed thyroid cancer cases and is the major histologic subtype influencing thyroid cancer incidence and mortality trends. PTC has a favorable prognosis, especially for those younger than 45, with an overall 20-year survival rate of over 90%. Thyroidectomy and radiofrequency ablation (RFA) are the two treatment options. Previously, the gold standard for treatment was surgery. However, RFA emerges as another less aggressive treatment and may be a promising alternative for patients who are intolerant of or unwilling to undergo surgery. Outcomes can be effectively assessed using the Thyroid Cancer-Specific Quality of Life (THYCA-Qol) scale, a disease-specific health-related quality of life questionnaire for thyroid cancer survivors. For interpretation, the raw scores are linearly transformed to a 0-100 scale, standardizing the score, and making it comparable with other quality-of-life instruments. Methods: The meta-analysis was performed following the PRISMA 2020 statement with articles published in PubMed, Scopus, and Embase that aligned with our inclusion and exclusion criteria. The observational cohort studies and randomized controlled trials comparing the THYCA-Qol posterior to RFA vs thyroidectomy were selected. Outcomes were analyzed according to the final score and specific components of THYCA-Qol clinical endpoints, including neuromuscular, voice, concentration, sympathetic, throat/mouth, psychological, sensory, scar, chilly, tingling, weight gain, headaches, and less interest in sex. Results: Five studies were initially included in the analysis for meeting the inclusion criteria. One study (Song et al, 2021) was excluded after sensitivity analysis because it included only patients with cancer located exclusively in the isthmus. Analyzing the four remaining studies, there was a statistical difference between the means of THYCA - QoL total score between the ablation group and surgery, being this one the most higher (-5.12, 95% CI: -9.92 to -0.32, p=0.002). When analyzing each component of the THYCA - QoL questionnaire, only the sensory component proved to have a statistically significant mean difference between both groups, again with the surgery group with higher scores (-7.14, 95% CI: -11.26 to -3.02, p < 0.00001). Conclusion: The findings of our meta-analysis show worse quality of life outcomes for patients with PTC treated with thyroidectomy versus RFA. This demonstrates how advantageous RFA is as an alternative to surgery, considering patients' perspectives. It is also important to highlight the need for more studies using QoL scores in different populations with standardized methodologies, as this would have allowed for a more accurate analysis with reduced heterogeneity. Presentation: Saturday, July 12, 2025