Comparison of radiofrequency ablation and microwave ablation for benign thyroid nodules: A systematic review and meta‐analysis

Abstract

Purpose To compare the effectiveness and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for the treatment of benign thyroid nodules (BTNs). Methods PubMed, Embase and Cochrane databases were searched up to September 11, 2020. Volume reduction rate (VRR), symptomatic and cosmetic scores analysed by standardized mean difference (SMD), and complications analysed by risk difference (RD) were performed to evaluate the efficacy and safety of RFA and MWA for treating BTNs. Results Five eligible studies were included. 899 patients with 956 BTNs and 869 patients with 938 BTNs received RFA and MWA, respectively. RFA and MWA have the similar pooled 3‐month (56.0% vs. 53.9%, p = .668) and 6‐month (80.8% vs. 74.9%, p = .080) VRRs. But RFA showed a significantly higher VRR than MWA after 12 months (86.2% vs. 80.0%, p = .036). The pooled symptomatic and cosmetic scores decreased significantly after 6 and 12 months in both RFA and MWA. The improvements of symptoms were equivalent between two groups at 6 (SMD: 1.17 vs. 1.12, p = .930) and 12 (SMD: 1.46 vs. 1.45, p = .930) months. No significant differences in cosmetic scores were found between two groups at 6 (SMD: 0.87 vs. 0.94, p = 0. 334) and 12 (SMD: 1.21 vs. 1.15, p = 0. 872) months. Major (RD = −0.02, P = .107) and minor (RD = 0.00, p = .661) complications did not significantly differ between RFA and MWA. Conclusions RFA and MWA are effective and safe treatment modalities for BTNs. But RFA showed a superior 12‐month VRR. RFA may have a better long‐term effect on volume reduction of nodules compared with MWA.

Long-Term Outcomes of Thermal Ablation for Benign Thyroid Nodules: The Issue of Regrowth

“…To our knowledge, there has been no report of the results of MWA or BTNs after >2 years of follow-up. Articles comparing the efficacy of RFA and MWA after a 1 year follow-up period reported that the results were similar [46,55].…”

Efficacy and Safety of Thermal Ablation for Treating Lymph Node Metastasis From Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis

“…In the ablation of thyroid nodules, some literatures have compared RFA with LA and found that RFA is faster than LA which led to a conclusion that regeneration is less but requires higher energy (43,44). There is also literature comparing RFA and MWA, suggesting that RFA may have a better long-term effect in reducing nodule volume (45).…”

Development and validation of a nomogram model for predicting residue of partially cystic thyroid nodules after ultrasound-guided ethanol and thermal ablation

“…And VRR after MWA was 53.9%, 74.9% and 80.0%, respectively. Significant decreased symptomatic and cosmetic scores were found after 6 and 12 months for both RFA and MWA (6). Besides, another study demonstrated that the incidence of hoarseness, hypothyroidism and postoperative pain were lower after thermal ablation compared to conventional thyroidectomy (9).…”

“…Thus, minimally invasive treatments are needed for benign PCTNs. Ultrasound(US)-guided thermal ablation, including radiofrequency ablation(RFA) and microwave ablation(MWA), was proved to be an effective substitute for surgery, which can decrease the nodule size significantly and simultaneously preserve the thyroid function and minimize complications (4)(5)(6)(7)(8). A metaanalysis showed that volume reduction rate (VRR) at 3, 6, and 12 months was 56.0%, 80.8% and 86.2% after RFA.…”