Long-term Efficacy and Safety of Thermal Ablation for Low-risk Papillary Thyroid Carcinoma

Papillary thyroid carcinoma (PTC), particularly low-risk papillary thyroid microcarcinoma (PTMC), is increasingly managed with less invasive strategies, including radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA). Short- and intermediate-term studies (≤5 years) have reported substantial tumor-volume reduction, high rates of local disease control, and low frequencies of major complications. However, extended follow‑up data remain comparatively scarce. Important uncertainties concern recurrence patterns, occult multifocal or microscopic disease, metastatic potential, reintervention requirements, and the preservation of thyroid and adjacent-structure function. International guidelines therefore remain cautious, reflecting ongoing debate about whether thermal ablation can provide durable oncologic control comparable to lobectomy or active surveillance in appropriately selected patients. Differences in patient selection, ablation techniques, imaging criteria, outcome definitions, and follow-up completeness further limit cross-study comparisons. Long-term prospective studies, comparative analyses, and real-world registries are needed to address these gaps and support evidence-based clinical decision-making.

This Research Topic seeks to consolidate high‑quality evidence on the efficacy and safety of thermal ablation for low‑risk PTC, with particular emphasis on disease control beyond preliminary short‑term findings. It will examine whether RFA, MWA, and LA provide durable local control comparable with surgery or active surveillance, and will investigate predictors of recurrence, progression, metastatic disease, treatment failure, and reintervention. Contributions should also clarify cumulative complication rates, vocal cord and parathyroid safety, thyroid-function preservation, autoimmune sequelae, and health-related quality of life. Comparative effectiveness studies and analyses of diverse real-world populations are encouraged to inform multidisciplinary risk–benefit assessments, refine patient-selection criteria, and guide future monitoring recommendations and clinical guidelines.

To gather further insights into long-term thermal ablation outcomes in appropriately selected patients with low-risk PTC (cT1a–bN0M0), we welcome Original Research, Clinical Trials, and Systematic Reviews addressing, but not limited to, the following themes:
o Long-term local tumor control and volume-reduction kinetics after RFA, MWA, or LA
o Recurrence patterns, metastatic potential, and predictors of disease progression
o Reintervention rates and outcomes following incomplete response or treatment failure
o Comparative effectiveness versus lobectomy and active surveillance
o Extended thyroid-function preservation and levothyroxine requirements
o Vocal cord, parathyroid, and other procedure-related complications
o Autoimmune sequelae and structural changes after thermal ablation
o Health-related quality of life and patient-reported outcomes
o Prospective cohorts, longitudinal studies, and real-world registries with complete follow-up
o Standardized definitions for treatment response, recurrence, complications, and surveillance outcomes
o Patient-selection criteria, ablation techniques, imaging protocols, and monitoring strategies
o Multidisciplinary consensus recommendations for long-term follow-up
o Reporting quality in accordance with STROBE and PRISMA standards, where applicable.