Abstract / Summary
The 2024 Expert Consensus has broadened the potential indications for thermal ablation in papillary thyroid carcinoma (PTC). This study classified PTC nodule locations to assess the efficacy and safety of radiofrequency ablation (RFA) for T1aN0M0 PTC in high-risk locations (HRL). This retrospective cohort study included 268 patients with T1aN0M0 PTC who underwent RFA between January 2020 and April 2024. Patients were classified into HRL and low-risk location (LRL) groups according to tumor location. RFA was conducted by senior radiologists with more than five years of experience. Follow-up lasted until September 2025. The primary endpoint was disease progression rate; secondary endpoints included tumor volume changes, complete tumor disappearance rate, and complication incidence. Median follow-up was 23.5 months. The overall complete tumor disappearance rate was 61.6%, with no significant difference between the HRL and LRL groups ( p = 0.665). After adjustment for baseline maximum tumor diameter using Firth penalized logistic regression, HRL classification was not significantly associated with disease progression (adjusted odds ratio, 1.77; 95% CI, 0.17–239.22; p = 0.689), and no significant associations were detected for complications, postoperative anxiety, or marked pain. In this retrospective cohort, no statistically significant differences in the observed outcomes were detected between the HRL and LRL groups. These preliminary findings support further evaluation of RFA performed by experienced operators in carefully selected patients with T1aN0M0 PTC in high-risk anatomical locations. Not applicable. This retrospective study only analyzed archived routine patient data with noactive intervention or diagnostic trial design, so trial registration was not needed.