{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:44:12Z","timestamp":1785908652753,"version":"3.56.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ultrasound-guided radiofrequency ablation (RFA) has become an established minimally invasive treatment for selected patients with low-risk papillary thyroid carcinoma (PTC). However, the safety and efficacy of RFA for PTCs located immediately adjacent to the thyroid capsule (\u22642 mm) remain insufficiently characterized because of the increased risk of thermal injury to adjacent critical structures. This study aimed to evaluate the safety and oncologic outcomes of ultrasound-guided RFA for solitary T1N0M0 PTC in this anatomically challenging setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study included 303 consecutive patients with solitary PTC located within 2\u00a0mm of the thyroid capsule who underwent ultrasound-guided RFA between June 2015 and December 2023. All diagnoses were confirmed by fine-needle aspiration, and all patients declined surgical treatment. Tumors were classified as T1a (n = 263) or T1b (n = 40). The primary efficacy endpoints were technical success and complete tumor disappearance. The primary safety endpoint was the incidence of procedure-related complications. Disease progression was assessed as a secondary endpoint. Patients underwent serial ultrasonographic follow-up according to a predefined protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Technical success was achieved in all patients (100%, 303\/303). After a median follow-up of 36 months, complete tumor disappearance of the treated tumor was observed in 294 patients (97.0%). The complete disappearance rate was higher in the T1a group than in the T1b group (98.1% [258\/263] vs 90.0% [36\/40]), and the difference was statistically significant (P &amp;lt;0.001). Disease progression occurred in five patients (1.65%), all in the T1a group, including four cases of newly developed primary thyroid carcinoma and one case of cervical lymph node metastasis. Procedure-related complications occurred in 10 patients (3.3%), all of whom experienced transient hoarseness that resolved spontaneously within 6 months. The complication rate was significantly higher in the T1b group than in the T1a group (10.0% [4\/40] vs 2.3% [6\/263]; P\u00a0= .034). BRAF\n                      <jats:sup>V600E<\/jats:sup>\n                      mutation status was not associated with disease progression (P\u00a0= .99).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ultrasound-guided RFA combined with hydrodissection and the lever maneuver is an effective and generally safe minimally invasive treatment option for solitary T1N0M0 PTC located adjacent to the thyroid capsule. Careful patient selection remains essential, as T1b tumors were associated with a numerically lower complete disappearance rate and a significantly higher risk of transient hoarseness compared with T1a tumors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1820010","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:45:50Z","timestamp":1785905150000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and efficacy of radiofrequency ablation for papillary thyroid carcinoma adjacent to the thyroid capsule"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuxi","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Ultrasound, Affiliated Hospital of Shandong Second Medical University","place":["Shan Dong, Weifang, China"]},{"name":"Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University","place":["Liaoning, Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfeng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University","place":["Liaoning, Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Affiliated Hospital of Shandong Second Medical University","place":["Shan Dong, Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaomiao","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Teacher Education, Weifang University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Che","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University","place":["Liaoning, Dalian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1001\/jama.2023.26348","article-title":"Thyroid cancer","volume":"331","author":"Boucai","year":"2024","journal-title":"Jama"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.990668","article-title":"Editorial: The role of genetic alterations in thyroid carcinoma","volume":"13","author":"Feldkamp","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2025.03.007","article-title":"Update in papillary thyroid cancer","volume":"54","author":"Kuenstner","year":"2025","journal-title":"Endocrinol Metab Clinics North America"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07128-6","article-title":"Long-term outcomes of radiofrequency ablation for unifocal low-risk papillary thyroid microcarcinoma: a large cohort study of 414 patients","volume":"31","author":"Yan","year":"2021","journal-title":"Eur Radiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1001\/jamasurg.2023.5202","article-title":"Long-term outcomes and risk factors of radiofrequency ablation for T1N0M0 papillary thyroid carcinoma","volume":"159","author":"Li","year":"2024","journal-title":"JAMA Surg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2019.0147","article-title":"Ultrasound-guided radiofrequency ablation versus surgery for low-risk papillary thyroid microcarcinoma: results of over 5 years\u2019 follow-up","volume":"30","author":"Zhang","year":"2020","journal-title":"Thyroid"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021202735","article-title":"Efficacy and safety of thermal ablation for treatment of solitary T1N0M0 papillary thyroid carcinoma: a multicenter retrospective 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Surg"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2023.2244713","article-title":"Efficacy and safety of ultrasound-guided radiofrequency, microwave and laser ablation for the treatment of T1N0M0 papillary thyroid carcinoma on a large scale: a systematic review and meta-analysis","volume":"40","author":"Gao","year":"2023","journal-title":"Int J Hyperthermia"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2025.110706","article-title":"Therapeutic outcomes and safety of radiofrequency ablation for primary papillary thyroid carcinoma: a game-changing meta-analysis","volume":"205","author":"Toraih","year":"2025","journal-title":"Radiother Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-025-00908-7","article-title":"Current evidence and strategies for preventing tumor recurrence following thermal ablation of papillary thyroid carcinoma","volume":"25","author":"Li","year":"2025","journal-title":"Cancer Imaging"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1820010\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:45:54Z","timestamp":1785905154000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1820010\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":16,"alternative-id":["10.3389\/fonc.2026.1820010"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1820010","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"article-number":"1820010"}}