Minimally Invasive Thermal Ablation for Papillary Thyroid Microcarcinoma: Feasibility Analysis in Primary Healthcare Settings.

Thyroid tumors are the most prevalent malignant neoplasms of the endocrine system, with an incidence approximately ten times higher than that of other endocrine tumors, accounting for 0.2%-1.0% of all malignant tumors (Zhu and Zhang, 2012 and Liu and Liao, 2017). Papillary thyroid microcarcinoma (PTMC) is a distinct subtype of papillary thyroid carcinoma (PTC), characterized by a maximum diameter of ≤ 10 mm. In recent decades, the incidence of PTC has tripled (Howlader, 2020). According to the 2014 World Health Organization (WHO) cancer report, over 50% of newly diagnosed thyroid cancer cases are PTMC (Soares et al., 2014). Furthermore, advancements in ultrasound (US) diagnostic techniques and the widespread adoption of US-guided fine-needle aspiration biopsy (US-FNAB) have led to a continued rise in the detection rate of PTMC (Bi, 2019). Among the various treatment modalities for PTMC, minimally invasive thermal ablation techniques offer substantial advantages over traditional surgical interventions, including enhanced safety, efficacy, minimal invasiveness, improved cosmetic outcomes, cost-effectiveness, ease of operation, and reduced anesthesia requirements. Moreover, these procedures are not confined to operating rooms and can be effectively performed in outpatient settings. Given these benefits, thermal ablation techniques hold great promise for widespread adoption in primary healthcare settings in China (primary healthcare facilities are critical for equitable access in resource-limited regions), as they not only reduce patient treatment costs but also optimize healthcare resource allocation, aligning with the national hierarchical medical system reform. This study aims to assess the feasibility of promoting the application of minimally invasive thermal ablation for PTMC in primary healthcare settings.