RNA M6A modification shaping cutaneous melanoma tumor microenvironment and predicting immunotherapy response.

Recent years have seen rising mortality rates linked to cutaneous melanoma (SKCM), despite advances in immunotherapy. Understanding RNA N6-methyladenosine (M6A) significance in SKCM is crucial for prognosis, tumor microenvironment (TME), immune cell presence, and immunotherapy efficacy. We analyzed 23 M6A regulators using SKCM samples from TCGA and GEO databases, identifying three M6A modification patterns linked to TME cell infiltration. Principal component analysis (PCA) yielded an M6A score for individual tumors, utilizing patient gene expression profiles and CNV data from TCGA. M6A modification patterns play a crucial role in SKCM development and progression, influencing tumor attributes such as inflammatory stage, subtype, TME interstitial activity, and genetic mutations. The M6A score independently predicts patient outcomes and correlates with improved response to immunotherapy, validated across anti-PD-1 and anti-PD-L1 therapy cohorts. M6A modifications significantly impact the TME landscape, with the M6A score serving as a predictive marker for immunotherapy response. Integrating M6A-related information into clinical practice could revolutionize SKCM management and treatment strategies.

Cyclic peroxides and analogs: Antibacterial, antimalarial, and cytotoxic marine products from Xisha sponge Diacarnus sp.

A chemical investigation of the dichloromethane extract from the Xisha sponge Diacarnus sp. revealed seven undescribed norterpene cyclic peroxides, named diacarperoxides T-Z, and five unreported related norterpenes, named diacarnoids E-I, and eleven previously reported compounds. The structures of these isolated compounds, including their absolute configurations, were elucidated based on extensive spectroscopic analyses, electronic circular dichroism (ECD) calculations, Snatzke's method, [Rh2(OCOCF3)4]-induced ECD spectra, and modified Mosher's method. Bioassays were performed to assess the antibacterial activity against six pathogenic bacteria, cytotoxicities toward three cancer cell lines, and antimalarial activity against Plasmodium parasites. Most of the cyclic peroxides exhibited substantial antibacterial activity (MIC 1-8 µg/mL). Diacarperoxide W and nuapapuin A showed substantial antimalarial activity with IC50 values of 0.98 and 2.83 µM. Moreover, many compounds exhibited <50% cell survival rates, and IC50 values of 0.22-6.33 µM. The apoptosis assay showed that nuapapuin A induced cancer cell apoptosis in a dose-dependent manner.

Phase separation of Nur77 mediates XS561-induced apoptosis by promoting the formation of Nur77/Bcl-2 condensates.

The orphan nuclear receptor Nur77 is a critical regulator of the survival and death of tumor cells. The pro-death effect of Nur77 can be regulated by its interaction with Bcl-2, resulting in conversion of Bcl-2 from a survival to killer. As Bcl-2 is overexpressed in various cancers preventing them from apoptosis and promoting their resistance to chemotherapy, targeting the apoptotic pathway of Nur77/Bcl-2 may lead to new cancer therapeutics. Here, we report our identification of XS561 as a novel Nur77 ligand that induces apoptosis of tumor cells by activating the Nur77/Bcl-2 pathway. In vitro and animal studies revealed an apoptotic effect of XS561 in a range of tumor cell lines including MDA-MB-231 triple-negative breast cancer (TNBC) and MCF-7/LCC2 tamoxifen-resistant breast cancer (TAMR) in a Nur77-dependent manner. Mechanistic studies showed XS561 potently induced the translocation of Nur77 from the nucleus to mitochondria, resulting in mitochondria-related apoptosis. Interestingly, XS561-induced accumulation of Nur77 at mitochondria was associated with XS561 induction of Nur77 phase separation and the formation of Nur77/Bcl-2 condensates. Together, our studies identify XS561 as a new activator of the Nur77/Bcl-2 apoptotic pathway and reveal a role of phase separation in mediating the apoptotic effect of Nur77 at mitochondria.

Thermal Rectification in Modularly Designed Bulk Metamaterials.

Thermal rectification is a phenomenon of great practical importance where heat transfer is preferential in one direction. Programmable control of heat transfer in 3D space is key to enable thermal rectification at the macroscale but is rarely realized in natural materials or in current existing devices that are constructed at the nano and microscales with high system complexity. Here, modularly designed bulk metamaterials that can break the symmetry of heat transfer from one direction to the other are created, leading to thermal rectification in convergent or divergent states by tuning the metamaterial microstructural design. These thermal metamaterials are microstructured composites made using one material composition, however, they offer sufficient microstructural design freedom to allow tunable local thermal properties for unusual macroscopic heat transfer. The strategy and performance achieved are promising for next-generation thermal management.

Using 3D printing-assisted shaping titanium cages and Masquelet techniques to reconstruct calcaneal osteomyelitis complicated by extensive soft tissue and uncontrolled defects.

OBJECTIVE: To investigate the clinical efficacy of three-dimensional (3D) printing-assisted shaping titanium cage combined with Masquelet technology in the treatment of calcaneal infectious defects. METHODS: A retrospective analysis was performed of the data from nine patients with chronic calcaneal infection defects treated with distal gastronal flap coverage and one patient with free anterolateral thigh flap coverage, also using a 3D printing-assisted shaping titanium cage combined with both mask technology and rib autografting from January 2017 to January 2019. There were seven males and three females, with a mean age of 37 years (range, 17-52 years). The injury mechanism of the 10 patients included four motor vehicle incidents, four high fall injuries, and two rolling compactions. All patients were treated by two⁃stage procedures. The first stage included debridement, polymethyl methacrylate (PMMA) filling, and regional flap coverage. The soft tissue defect of the 10 cases included 80 cm2 in four cases and 56 cm2, 40 cm2, and 15 cm2 in each of two cases. The bone defect was 24 cm3 and 18 cm3 in each of four cases and 3 cm3 in two cases. The second stage was the mask technology of 3D printing-assisted shaping titanium cage combined with rib autografting. Time of bone union, calcaneus morphology, implant position, and the Maryland and AOFAS hind foot scores were recorded to evaluate the clinical outcome. RESULTS: All 10 patients were followed up for a mean of 18.5 months (range, 12-30 months). Infection occurred in two patients 2 months after the first stage operation and were successfully treated by debridement and PMMA replacement. The incision of the other eight cases all healed successfully. Cultures from the 10 cases included five cases of methicillin-resistant Staphylococcus aureus, three cases of S. aureus, and one case each of Escherichia coli and Pseudomonas aeruginosa. All 10 patients exhibited calcaneus bone union after the second stage operation. The mean time for bone union was 4.32 (range, 3-8) months. Bone trabeculae were observed in a CT scan 13 (range, 10-22) months post-operation. The mean Maryland score at 12 months post-operation was 92 (range, 86-98) and the mean AOFAS ankle hind foot score was 89.8 (range, 83-100). CONCLUSION: Three-dimensional printing-assisted shaping titanium cages and Masquelet technology may be effective methods for the treatment of infectious calcaneal defects.

Wild vs. Cultivated Zingiber striolatum Diels: Nutritional and Biological Activity Differences.

Compositional, functional, and nutritional properties are important for the use-value assessments of wild and cultivated edible plants. The aim of this study was to compare the nutritional composition, bioactive compounds, volatile compounds, and potential biological activities of cultivated and wild Zingiber striolatum. Various substances, such as soluble sugars, mineral elements, vitamins, total phenolics, total flavonoids, and volatiles, were measured and analyzed using UV spectrophotometry, ICP-OES, HPLC, and GC-MS methods. The antioxidant capacity of a methanol extract of Z. striolatum, as well as the hypoglycemic abilities of its ethanol and water extracts, were tested. The results showed that the contents of soluble sugar, soluble protein, and total saponin in the cultivated samples were higher, while the wild samples contained higher amounts of K, Na, Se, vitamin C, and total amino acids. The cultivated Z. striolatum also showed a higher antioxidant potential, while the wild Z. striolatum exhibited a better hypoglycemic activity. Thirty-three volatile compounds were identified using GC-MS in two plants, with esters and hydrocarbons being the main volatile compounds. This study demonstrated that both cultivated and wild Z. striolatum have a good nutritional value and biological activity, and can be used as a source of nutritional supplementation or even in medication.

Predictors of metastasis in cervical indeterminate lymph nodes after thyroid cancer ablation by long-term ultrasound follow-up.

OBJECTIVES: To investigate the pattern of change over time and predictors for metastasis in indeterminate lymph nodes (LNs) among patients with thyroid cancer post-ablation. METHODS: We enrolled patients who developed new cervical LNs after papillary thyroid carcinoma (PTC) ablation. Changes in the ultrasound characteristics of the indeterminate LN were recorded at months 1, 3, 6 and 12 after ablation. LN puncture pathology and long-term follow-up were standard of diagnosis. The indeterminate LNs were divided into benign and malignant groups, the differences between the two groups were compared, and the risk characteristics of malignant LNs were screened using generalized estimating equations (GEE). RESULTS: In total, we included 138 LNs from 99 patients, of which 48 were indeterminate LNs. When following up indeterminate LNs, non-cervical lymph node metastasis (non-CLNM) lesions demonstrated a statistically significant gradual decrease in volume (p = 0.012), though there was no significant change in the volume of CLNM lesions (p = 0.779). Compared to non-CLNM lesions, the diagnostic efficiency was the highest for CLNM lesions at 1-3 months after ablation, when the LN volume changed by -0.08 to 0.12 mL (p = 0.048). The third month after ablation became an important time point for review. Moreover, GEE analysis showed that microcalcifications, cystic changes, and vascularity were strongly associated with CLNMs (p = 0.004, p = 0.002, and p = 0.010, respectively). CONCLUSIONS: There is a pattern of volume change of indeterminate LNs after PTC ablation, which, together with microcalcifications, cystic changes, and vascularity, can be used as criteria for differentiating the benignity and malignancy of indeterminate LNs.

Lymphatic Contrast-enhanced US to Improve the Diagnosis of Cervical Lymph Node Metastasis from Thyroid Cancer.

Background The presence of cervical lymph node (LN) metastases (LNMs) affects clinical staging and prognosis of thyroid cancer, but the role of conventional B-mode US is limited for preoperative diagnosis of LNMs. The diagnostic value of lymphatic contrast-enhanced US (LCEUS) in thyroid cancer is still being explored. Purpose To explore the diagnostic performance of LCEUS by means of thyroidal injection of contrast agent in comparison with US in detecting LNMs of suspected thyroid cancer. Materials and Methods In this single-center prospective study conducted from November 2020 to January 2021, consecutive participants with suspected thyroid cancer underwent B-mode US and LCEUS of cervical LNs before biopsy. LNMs were confirmed with fine-needle aspiration cytologic examination, thyroglobulin washout assessment, or histopathologic examination after surgery. The diagnostic performance of LCEUS for cervical LNs was compared with that of conventional B-mode US, and its association with LN size and location was evaluated. Results The final data set included 64 participants (mean age, 45 years ± 12 [SD]; 52 women) with 76 LNs. The sensitivity, specificity, and accuracy of LCEUS for LNM were 97%, 90%, and 93%, respectively, whereas they were 81%, 80%, and 80%, respectively, for LNM at conventional B-mode US. Compared with US, LCEUS had better diagnostic accuracy for the LNs smaller than 1 cm (82% vs 95%; P = .03) and for central neck LNs (level VI) (83% vs 96%; P = .04). Conclusion Lymphatic contrast-enhanced US had better diagnostic performance than conventional B-mode US for detecting cervical LN metastases in suspected thyroid cancer before surgery, especially for LNs smaller than 1 cm and central neck LNs. © RSNA, 2023 See also the editorial by Grant and Kwon in this issue.

Observation of the therapeutic effect of apatinib in advanced platinum-resistant recurrent epithelial ovarian cancer.

BACKGROUND: Apatinib is an oral anti-angiogenic drug that mainly targets vascular endothelial growth factor receptor 2 (VEGFR-2) and is widely used in a variety of solid tumours. The purpose of this study is to evaluate the clinical efficacy and safety of apatinib in patients with advanced platinum-resistant relapsed epithelial ovarian cancer (EOC). METHODS: A retrospective analysis was performed, the clinical data of patients with stage IIIC-IV platinum-resistant relapsed EOC between January 2014 and May 2018 were collected. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were reviewed and evaluated. The propensity score matching (PSM) method was used to determine the final case data included in this study. RESULTS: According to 1:2 propensity matching, 108 patients were finally taken into account: 36 in the apatinib group and 72 in the control group. The follow-up ended in January 2019, and the median follow-up time was 28 months. In the apatinib group, ORR was 30.56% and DCR was 66.67%, whereas in the control group, ORR was 16.67% and DCR was 44.44%. In the apatinib group, median PFS was 6.0 months (95% CI 3.69-8.31) and median OS was 15.8 months (95% CI 6.99-24.6), while in the control group, median PFS was 3.3 months (95% CI 2.44-4.16) and median OS was 9.2 months (95% CI 6.3-12.06); the difference was statistically significant (P < 0.05). Apatinib was more effective than conventional chemotherapy in reducing the risk of PFS [HR 0.40 (95% CI 0.22-0.76), P = 0.0017] and OS [HR 0.40 (95% CI 0.21-0.73), P = 0.002]. Multivariate Cox analysis showed that the course of treatment and decrease in serum CA125 levels are independent risk factors for PFS in patients, while apatinib, the length of treatment course and the location of the lesion are independent risk factors for recurrence affecting the OS of patients. The main grade 3-4 adverse events in the apatinib group were hypertension, hand-foot syndrome, and oral mucosal ulcers, and all adverse events were controllable. CONCLUSION: Apatinib was found to be both safe and effective in patients with advanced platinum-resistant relapsed EOC. More in-depth clinical research and applications should be carried out.

Processing and Properties of Garnet-Type Li7 La3 Zr2 O12 Ceramic Electrolytes.

Garnet-type solid electrolyte Li7 La3 Zr2 O12 (LLZO) is widely considered as one of the most promising candidates for solid state batteries (SSBs) owing to its high ionic conductivity and good electrochemical stability. Since its discovery in 2007, great progress has been made in terms of crystal chemistry, chemical and electrochemical properties, and battery application. Nonetheless, reliable and controllable preparation of LLZO ceramics with desirable properties still remains as big challenges. Herein, this review summarizes various synthetic routes of LLZO ceramics and examines the influence of various key processing parameters on the chemical and electrochemical properties. Focusing on correlation of processing parameters and properties, this review aims to provide new insights on a reliable and controllable production of high-quality LLZO ceramic electrolytes for SSB application.

Microstructured BN Composites with Internally Designed High Thermal Conductivity Paths for 3D Electronic Packaging.

Miniaturized and high-power-density 3D electronic devices pose new challenges on thermal management. Indeed, prompt heat dissipation in electrically insulating packaging is currently limited by the thermal conductivity achieved by thermal interface materials (TIMs) and by their capability to direct the heat toward heat sinks. Here, high thermal conductivity boron nitride (BN)-based composites that are able to conduct heat intentionally toward specific areas by locally orienting magnetically functionalized BN microplatelets are created using magnetically assisted slip casting. The obtained thermal conductivity along the direction of alignment is unusually high, up to 12.1 W m-1 K-1 , thanks to the high concentration of 62.6 vol% of BN in the composite, the low concentration in polymeric binder, and the high degree of alignment. The BN composites have a low density of 1.3 g cm-3 , a high stiffness of 442.3 MPa, and are electrically insulating. Uniquely, the approach is demonstrated with proof-of-concept composites having locally graded orientations of BN microplatelets to direct the heat away from two vertically stacked heat sources. Rationally designing the microstructure of TIMs to direct heat strategically provides a promising solution for efficient thermal management in 3D integrated electronics.

Efficacy and safety of radiofrequency ablation for calcified benign thyroid nodules: results of over 5 years' follow-up.

PURPOSE: To evaluate the efficacy and safety of radiofrequency ablation (RFA) for treating calcified benign thyroid nodules (CBTNs). METHODS: Fifty-two patients with 52 CBTNs who underwent RFA in our hospital were included in this retrospective study. According to the size of calcifications, CBTNs were divided into two groups: the punctate echogenic foci (PEF) group and macrocalcification group. Moreover, the macrocalcification group was further subdivided into two groups, the strong group and the weak group, based on their morphologic characteristics. After the RFA procedure, routine ultrasound (US) and clinical evaluation were performed at 1, 3, 6 and 12 months postoperatively and every 12 months thereafter. RESULTS: The mean follow-up time was 68.98 ± 7.68 months (60-87 months), and the 5-year mean volume reduction rate (VRR) after RFA was 92.95%, with a complication rate of 0.6% (3/52). The mean initial volume of the macrocalcification group was significantly larger than that of the PEF group (9.94 ± 24.60 ml vs. 0.23 ± 0.22 ml, respectively; P = 0.011). Thus, their VRRs were not comparable between the two groups. However, baseline characteristics did not show statistically significant differences between the strong and weak macrocalcification subgroups. The VRRs of the strong subgroup were significantly lower than those of the weak subgroup at the 3-year, 4-year, and 5-year follow-ups. CONCLUSION: RFA was effective and safe for treating CBTNs. Strong macrocalcification was related to the VRR of CBTNs after the RFA procedure.

[Comparison between Ultrasonography and CT in Diagnosis of Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma].

Objective To evaluate the efficacy of ultrasound and computed tomography (CT) in diagnosing cervical lymph node metastasis (CLNM) of papillary thyroid carcinoma (PTC). Methods The patients with PTC treated by surgery in the Chinese PLA General Hospital from January 2016 to January 2021 were selected for analysis.All the patients underwent preoperative ultrasound and CT examinations,the diagnostic values of which for CLNM were retrospectively analyzed. Results A total of 322 PTC patients were enrolled in this study,including 242 with CLNM and 80 with non-CLNM.The CLNM group and non-CLNM group had significant differences in age,tumor size,and maximum size of lateral CLNM (χ2=20.34,27.34,and 4.30,respectively,all P<0.001).For the central compartment,lateral compartment,and overall compartment,ultrasound diagnosis showed higher sensitivity (χ 2=82.26,P<0.001;χ2=114.01,P<0.001;χ2=82.26,P<0.001) and accuracy (χ2=20.27,P<0.001;χ2=15.56,P<0.001;χ2=44.00,P<0.001) than CT,and had no significant differences from ultrasound combined with CT (all P>0.05).However,ultrasound diagnosis had lower specificity than CT (χ2=17.01,P<0.001;χ2=21.29,P<0.001) in the central compartment and lateral compartment.Receiver operating characteristic curve analysis showed that in the central compartment,lateral compartment,and overall compartment,ultrasound diagnosis had larger AUC than CT (Z=2.99,P=0.003;Z=3.86,P<0.001;Z=4.47,P<0.001) and had no significant difference from ultrasound combined with CT (Z=1.87,P=0.062;Z=1.68,P=0.093;Z=1.61,P=0.107). Conclusions Ultrasound and CT have their own advantages in the diagnosis of central and lateral CLNM.In general,ultrasound has better performance than CT in the diagnosis of CLNM.

Teaching Radiology to Medical Students in Canada; a Virtual, Integrative, Clinical Approach.

PURPOSE: To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students. METHODS: A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems. The target audience was medical students of Canadian schools. Pretests and post-tests were administered before and after each session respectively. An evaluation survey was distributed at the end of the course to gauge students' perceptions of this experience. RESULTS: An average of 425 medical students attended the live sessions. For each session, 405 students completed both the pre-tests and post-tests. In general, students scored an average of 56% higher on the post-test than on the pre-test. The final course survey was completed by 469 students. The survey results show that more than 98% of students found the course to meet or exceed their expectations. Over 80% of students agreed that the course increased their interest in radiology and about 81% agree that the topics presented were excellent and clinically important. The ratings in the final survey results also indicate that students increased their confidence in basic radiology skills after completing the course. CONCLUSIONS: The implementation of an integrative clinical approach to teaching radiology in a virtual setting is achievable. It provides efficient use of educational resources while being accessible by a large number of students across different medical schools.

Contrast-enhanced ultrasound is a reliable and reproducible assessment of necrotic ablated volume after radiofrequency ablation for benign thyroid nodules: a retrospective study.

PURPOSE: To investigate the intra- and inter-observer reliability and agreement of contrast-enhanced ultrasound (CEUS) in measuring ablated volume (Va) after radiofrequency ablation (RFA) for benign thyroid nodules. MATERIALS: This retrospective study evaluated 65 patients with 74 benign thyroid nodules who underwent RFA. Patients were followed up at 1, 3, 6, and 12 months and every 12 months thereafter. Two independent observers measured the Va using CEUS during the same follow-up visit. The intra- and inter-observer reliability was assessed using intraclass correlation coefficient (ICC) with 95% confidence interval. The Bland-Altman analysis was used to evaluate the inter-observer agreement, which was expressed as a mean difference with 95% limit of agreement (LOA). RESULTS: No significant difference was found in Va measurements by the two observers with a mean follow-up time of 41.17 ± 16.80 months (all p > 0.05). The intra- and inter-observer reliability were both excellent (ICC >0.90) at each follow-up period. The 95% LOA became wider over the follow-up period. The smallest 95% LOA was found at 1 month with a LOA from 0.8117 to 1.122, and the largest 95% LOA was from 0.5694 to 1.343 at 36 months. CONCLUSIONS: CEUS could provide a reliable and reproducible assessment of Va after RFA for benign thyroid nodules. In clinical post-ablation follow-up, the irregular morphology of ablated area and the variation by different observers could not affect the assessment of Va by CEUS.

Efficacy and Safety of the Remimazolam-Alfentanil Combination for Sedation During Gastroscopy: A Randomized, Double-blind, Single-center Controlled Trial.

PURPOSE: Propofol infusion is a popular single drug of choice for sedation in the gastrointestinal endoscopy suite. Drug combinations are more beneficial than single-drug regimens in gastroscopy sedation. However, the cardiopulmonary complications of propofol sedation raise concern. Remimazolam is a novel, ultra-short-acting benzodiazepine sedative, and alfentanil is a weak opioid. During endoscopic procedures, remimazolam is an effective and safe sedative procedure. No synergistic effect has been reported when remimazolam was combined with alfentanil in gastroscopy sedation. Here, we evaluated the effective dose, sedative efficacy, and safety of the remimazolam-alfentanil combination in gastroscopy sedation and compared the results with those of the propofol-alfentanil combination. METHODS: This study was conducted in two parts. In Part 1, Dixon's up-and-down method (sequential distribution) was adopted for determining the 95% effective dose (ED95) (95% CI) and 95% CI of remimazolam combined with 5 µg/kg alfentanil. In Part 2, after obtaining the predictive remimazolam ED95, 161 patients were randomized into the remimazolam group (remimazolam-alfentanil) and the propofol group (propofol-alfentanil). The effectiveness of the drug combinations was measured according to successful sedation parameters. Changes in vital signs and the appearance of adverse events were used to assess the safety of drug combinations. Evaluation of patient and physician satisfaction was included as quality indicators of treatment. RESULTS: Baseline demographic and clinical characteristics were comparable between the 2 parts of the study. The ED95 of remimazolam in inhibiting a positive response to gastroscopy placement into the pharyngeal cavity was 0.33 mg/kg (95% CI, 0.289 to 1.023). The procedure success rate was 97.53% in the remimazolam group and 97.50% in the propofol group. The difference in the success rate of the procedure between the remimazolam and propofol groups was 0.03% (95% CI, -2.5 to 2.4). However, the incidence of injection pain, hypotension, respiratory depression, and dizziness was lower in the remimazolam group compared with the propofol group (P < 0.05). Furthermore, patients from the propofol group were more likely to be drowsy, and their work efficiency was reduced the day after leaving the hospital, whereas patients in the remimazolam group were less affected (P < 0.05). IMPLICATIONS: The ED95 of remimazolam was 0.33 mg/kg when it was combined with alfentanil (5 µg/kg) for gastroscopy sedation. The sedation strategy of remimazolam-alfentanil has noninferior efficacy, fewer adverse effects, and a better postoperative recovery process than propofol-alfentanil for patients undergoing gastroscopy. Chinese Clinical Trials Registry identifier: ChiCTR2100051565.

Ultrasound-Guided Radiofrequency Ablation Versus Surgical Resection for the Treatment of T1bN0M0 Papillary Thyroid Carcinoma in Different Age Groups.

Purpose: We aimed to compare the efficacy and safety of radiofrequency ablation (RFA) to that of surgical resection (SR) in patients with T1bN0M0 papillary thyroid carcinoma (PTC) in different age groups. Methods: Totally, 204 patients with an isolated, solitary, intrathyroidal T1bN0M0 PTC, who underwent either RFA (n=94) or SR (n=110) between April 2014 and December 2019, were retrospectively enrolled and were divided into two subgroups according to age (<45 years, ≧45 years). Patients with pathologically aggressive or advanced lesions were excluded from the study. Tumor progression and procedural complications were the primary and secondary endpoints, respectively. Tumor recurrence in situ, newly discovered tumors, lymph node involvement, or distant metastases indicated tumor progression. Complications included pain, fever, voice change, choking, numbness in the limbs, and cardiac events. Incidence rates of all endpoint events were compared between different age subgroups. Results: There were no significant differences in age, sex, and tumor size between the treatment groups. While the RFA group incurred less cost and experienced significantly shorter operative duration than the SR group, no significant differences were observed in incidences of both tumor progression and complications. Further, subgroup analysis of patients <45 years versus those ≧45 years showed no significant differences in the incidence of tumor progression and complications within or between different treatment groups. Older patients in the SR group incurred higher hospital costs than younger counterparts, but this difference was not observed in the RFA group. Conclusions: Our results indicated that RFA had a similar prognosis as that of SR but was associated with lower overall cost in both young (<45 years) and middle-aged patients (≧45 years) with T1bN0M0 PTC. Therefore, RFA may be an effective and safe alternative to surgery for the treatment of patients with T1bN0M0 PTC.