Placing Thermal Ablation for Benign Thyroid Nodules into Context

Negro, Roberto; Trimboli, Pierpaolo

doi:10.1159/000509310

Cited by 1 publication

(1 citation statement)

References 19 publications

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“…In these cases, contrast-enhanced rather than non-enhanced ultrasound might provide useful information on the treatment outcome [ 51 , 52 ]. Additional classifiers based not only on clinical and US features, but also on molecular markers [ 53 ] and artificial intelligence might help predict treatment response as well as nodule behaviour over time [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Current Status and Challenges of US-Guided Radiofrequency Ablation of Thyroid Nodules in the Long Term: A Systematic Review

Bernardi

Palermo

Grasso

et al. 2021

Cancers

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Background: US-guided minimally-invasive techniques, such as radiofrequency ablation (RFA) have emerged as an alternative treatment for benign and malignant thyroid nodules. This systematic review aims to provide an overview on the long-term outcomes of US-guided RFA in patients with benign and malignant thyroid nodules. Methods: We systematically searched PubMed/MEDLINE, EMBASE, and Scopus to identify articles reporting the outcomes of thyroid RFA after a follow-up of at least 3 years. Results: A total of 20 studies met the inclusion criteria and were included in the review. In patients with benign thyroid nodules, RFA significantly reduced nodule volume and this was generally maintained for the following 5 years. However, a small but not negligible proportion of nodules regrew and some of them required further treatments over time. In patients with malignant nodules, RFA has been used not only to treat differentiated thyroid cancer (DTC) neck recurrences, but also to treat papillary thyroid microcarcinoma (PTMC). In most patients with PTMC, RFA led to complete disappearance of the tumor. When it was compared to surgery, RFA was not inferior in terms of oncologic efficacy but it had a lower complication rate. However, RFA did not allow for final pathology, disease staging and accurate risk stratification. Conclusions: US-guided RFA significantly reduces benign thyroid nodules and destroys most PTMC, and this is generally maintained for at least 5 years after the initial treatment. Further studies addressing the risk of regrowths in patients with benign thyroid nodules, as well as the risk of recurrence in patients with PTMC are needed.

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