Economic effect between surgery and thermal ablation for patients with papillary thyroid microcarcinoma: a systemic review and meta-analysis

Background At present, there are still many controversies regarding the treatment of papillary thyroid microcarcinoma (PTMC). It is worth noting that thermal ablation has become a viable alternative for patients at high risk of surgery or those who wish to receive more active treatment than active surveillance. Objective To investigate the economic benefits, efficacy, and safety of thermal ablation for patients with PTMC. Methods We searched PubMed, Cochrane Library, Web of Science, and Embase for articles published from the database establishment to August 2021. All of the studies included were retrospective cohort analyses. In addition, meta-analysis was performed using the Stata15.1 versions and Review Manager5.3. Data were extracted according to the PRISMA guidelines by two professional doctors. Results A total of 7 articles (1582 patients) were included in our systematic review and meta-analysis. We discovered that thermal ablation could shorten the hospitalization time (SMD, −3.82[95%CI, −5.25 to −2.40]), operation time (SMD, −5.67[95%CI, −6.65 to −4.68]), cost (SMD, −3.40 [95%CI, −5.06 to −1.75]) and reduce postoperative complications (OR, 0.07 [95%CI, 0.01 to 0.44]) than surgical treatment. In addition, our study also found that compared with surgery, there was no significant difference in the recurrence rate (OR, 1.53 [95% CI, 0.63 to 3.73]) and metastasis rate (OR, 0.47 [95% CI, 0.12 to 1.86]). Conclusion On the premise of being safe and effective, thermal ablation has better economic benefits than surgical treatment for patients with PTMC.