OBJECTIVE: To summarize the literature published to date on the use of radiofrequency ablation (RFA) in the treatment of benign thyroid nodules, to evaluate the effectiveness of this treatment, and to attempt an evaluation of factors that may influence treatment outcome. STUDY DESIGN: Systematic review with meta-analysis. METHODS: Systematic literature search was performed by two separate authors in four commonly used literature databases. Trials included in meta-analysis included only those presenting prospective data. Meta-analysis compared pretreatment values to post-treatment outcomes. RESULTS: Of 46 full-text articles identified, nine articles satisfied inclusion criteria. Two of these articles were randomized controlled trials comparing RFA to placebo or to some other treatment. One article was a randomized controlled trial comparing one RFA treatment to two treatments. The remaining six articles were noncontrolled, prospective observational studies. All analyzed outcomes showed statistically significant improvements from baseline to final follow-up, including reduction in nodule size, improvement of symptom and cosmetic scores, and withdrawal from methimazole. Improvement in nodule size remained significant in both "hot" and "cold" nodule subgroups. Twelve adverse events were identified across all studies out of 306 total treatments. Two of these events qualified as significant adverse events. None of these events resulted in hospitalization or death. CONCLUSIONS: Radiofrequency ablation is a safe and effective treatment for symptomatic thyroid nodules that are confirmed benign. However, the paucity of level 1 evidence comparing RFA to surgical or to other nonsurgical treatment modalities is concerning.
OBJECTIVE: To summarize the literature published to date on the use of radiofrequency ablation (RFA) in the treatment of benign thyroid nodules, to evaluate the effectiveness of this treatment, and to attempt an evaluation of factors that may influence treatment outcome. STUDY DESIGN: Systematic review with meta-analysis. METHODS: Systematic literature search was performed by two separate authors in four commonly used literature databases. Trials included in meta-analysis included only those presenting prospective data. Meta-analysis compared pretreatment values to post-treatment outcomes. RESULTS: Of 46 full-text articles identified, nine articles satisfied inclusion criteria. Two of these articles were randomized controlled trials comparing RFA to placebo or to some other treatment. One article was a randomized controlled trial comparing one RFA treatment to two treatments. The remaining six articles were noncontrolled, prospective observational studies. All analyzed outcomes showed statistically significant improvements from baseline to final follow-up, including reduction in nodule size, improvement of symptom and cosmetic scores, and withdrawal from methimazole. Improvement in nodule size remained significant in both "hot" and "cold" nodule subgroups. Twelve adverse events were identified across all studies out of 306 total treatments. Two of these events qualified as significant adverse events. None of these events resulted in hospitalization or death. CONCLUSIONS: Radiofrequency ablation is a safe and effective treatment for symptomatic thyroid nodules that are confirmed benign. However, the paucity of level 1 evidence comparing RFA to surgical or to other nonsurgical treatment modalities is concerning.
Authors: Christian Erbelding; Alfred Franz; Alexander Seitel; Nasrin Bopp; Konstantin Kohlhase; Frank Grünwald; Lena Maier-Hein Journal: Int J Comput Assist Radiol Surg Date: 2017-03-07 Impact factor: 2.924
Authors: Antonio Barile; Simone Quarchioni; Federico Bruno; Anna Maria Ierardi; Francesco Arrigoni; Aldo Victor Giordano; Sergio Carducci; Marco Varrassi; Giampaolo Carrafiello; Ferdinando Caranci; Alessandra Splendiani; Ernesto Di Cesare; Carlo Masciocchi Journal: Gland Surg Date: 2018-04
Authors: Gee Mun Lee; Ji Young You; Hoon Yub Kim; Young Jun Chai; Hong Kyu Kim; Gianlorenzo Dionigi; Ralph P Tufano Journal: Endocrine Date: 2018-12-19 Impact factor: 3.633
Authors: Yücel Korkusuz; Alexander Mader; Daniel Gröner; Shadi Ahmad; Oscar Maximilian Mader; Frank Grünwald; Christian Happel Journal: World J Surg Date: 2017-10 Impact factor: 3.352