Expanding the role of thermal ablation in thyroid cancer beyond low-risk unifocal PTMC: a review … — International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group (2026)

Resumo clínico (PT)

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Abstract (original)

Thermal ablation (TA) is an established treatment for low-risk unifocal papillary thyroid microcarcinoma (PTMC) and has been incorporated into several clinical guidelines. However, its clinical indications remain limited and do not fully encompass more advanced tumor stages, multifocal disease, or non-papillary histological subtypes. This review summarizes current evidence regarding the expanded application of TA in thyroid cancers beyond low-risk unifocal PTMC. A comprehensive literature search was conducted in PubMed, Embase, and Web of Science from database inception to May 2025. Eligible studies evaluating ultrasound-guided thermal ablation for papillary thyroid carcinoma beyond low-risk PTMC were identified according to predefined inclusion and exclusion criteria. Titles and abstracts were screened, followed by full-text assessment of potentially relevant articles. Relevant data were subsequently extracted for qualitative synthesis. A total of 24 studies involving 1,940 patients with thyroid cancer beyond low-risk unifocal PTMC were included. The available evidence indicates that TA is technically feasible and minimally invasive in selected extended indications, achieving favorable short- to mid-term tumor control. In comparative studies, TA was generally associated with lower complication rates than surgery in appropriately selected patients. However, most included studies were retrospective in design, and long-term oncologic outcomes remain insufficiently reported, particularly for higher-risk pathological subtypes. TA may represent a minimally invasive therapeutic option for selected thyroid cancers beyond low-risk unifocal PTMC. Nevertheless, prospective studies with extended follow-up and direct comparative analyses with surgical management are required to better define its long-term oncologic role.