Comparison of health-related quality of life between radiofrequency ablation and surgery for unifocal T1N0M0 papillary thyroid carcinoma: follow-up study with up to 5 years of observation

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. 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 March 2018 and March 2023. 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. 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. 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. Our study suggests that RFA provides better cosmetic, and HRQoL outcomes for T1N0M0 PTC patients.