Comparison of ultrasound-guided percutaneous radiofrequency ablation and reoperation for nerve-adjacent cervical lymph node recurrence of papillary thyroid carcinoma: a propensity score–matched study

Objectives: To compare the short-term efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) and reoperation (RO) for recurrent papillary thyroid carcinoma presenting as solitary cervical lymph node metastasis (R-PTC-SCLNM) located in perineural regions (PNRs). Methods: This retrospective study included patients with R-PTC-SCLNM in PNRs who underwent RFA or RO. Propensity score matching was performed to balance baseline characteristics. Kaplan-Meier analysis was used to assess recurrence-free survival, and treatment outcomes and complications were compared between groups. Subgroup analyses were conducted according to the anatomical relationship between metastatic lymph nodes and adjacent nerves. Results: After PSM, 71 matched pairs were included. In the RFA group, the mean volume reduction ratio (VRR) at 24 months was 0.97 ± 0.04, and 42.3% of metastatic lymph nodes had completely disappeared. The overall local recurrence rate did not differ significantly between the RFA and RO groups, consistent with the Kaplan-Meier analysis. The RFA group had significantly lower overall complication rates than the RO group (P