Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study

Yue, Wenwen; Wang, Shurong; Lu, Feng; Li, Xiao‐Long; Xu, Hui‐Xiong; Sun, Liping; Guo, Le‐Hang; He, Yaping; Wang, Dan; Yin, Zhiqiang

doi:10.1038/srep37838

Cited by 71 publications

(58 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Currently, RFA is used as the sole non-surgical alternative in our institution, and the possibility of employing other techniques remains. Finally, RFA has been reported to provide better quality of life than open surgery for benign thyroid nodules [38,39]; future studies on assessing quality of life in recurrent thyroid cancer patients treated with various minimally invasive techniques would be needed.…”

Section: Discussionmentioning

confidence: 99%

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Choi

Jung

Bae

et al. 2019

International Journal of Hyperthermia

View full text Add to dashboard Cite

2019) Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study, International ABSTRACT Purpose: To compare the efficacy and complication rates of radiofrequency ablation (RFA) and repeat surgery in the treatment of locally recurrent thyroid cancers. Materials and methods: A total of 221 patients with locally recurrent thyroid cancers who underwent either RFA (n ¼ 96) or repeat surgery (n ¼ 125) between March 2008 and March 2017 were retrospectively enrolled (range of follow-up, 1-10 years). Each cohort consisted of 70 patients after propensity score adjustment. Patients with more than three recurrent lesions were excluded. The primary and secondary end points were recurrence-free survival and complication rates, respectively. Recurrence-free survival curves were compared via the logrank test. The complications-voice changes, hypocalcemia, and immediate procedural complications-were compared between the groups. In addition, pretreatment serum thyroglobulin (T g ) levels and those at the last follow-up were also compared between the two groups to examine therapeutic efficacy. Results: After propensity score matching, both groups showed no significant differences in baseline characteristics. The recurrence-free survival rates were comparable between the RFA and surgery groups (p ¼ .2). There were no significant differences in mean serum T g levels and their mean decrease after treatment between the groups (p ¼ .891 and p ¼ .963, respectively). Immediate procedural complications and voice changes also showed no significant between-group differences (p ¼ .316, p ¼ .084, respectively). Hypocalcemia occurred only in the repeat surgery group (n ¼ 18). Overall complications were significantly more frequent in the repeat surgery group (RFA, n ¼ 7; surgery, n ¼ 27; p < .001). Conclusion: RFA may be an effective and safe alternative to repeat surgery in the treatment of a small number of locally recurrent thyroid cancers. ARTICLE HISTORY

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Choi

Jung

Bae

et al. 2019

International Journal of Hyperthermia

View full text Add to dashboard Cite

show abstract

“…Knowing whether one single session will result in a satisfactory effect or whether more than one session will be required to solve the mass effect is important, not only for the clinical outcome, but also for economic reasons. Few studies have evaluated the cost of thermal treatment versus surgery, and though the costs of one single thermal treatment may appear to be smaller, the cost obviously increases when more than one session is needed [31,32].…”

Section: Discussionmentioning

confidence: 99%

Machine Learning Prediction of Radiofrequency Thermal Ablation Efficacy: A New Option to Optimize Thyroid Nodule Selection

Negro¹,

Rucco²,

Creanza³

et al. 2019

Eur Thyroid J

View full text Add to dashboard Cite

Background: Radiofrequency (RF) is a therapeutic modality for reducing the volume of large benign thyroid nodules. If thermal therapies are interpreted as an alternative strategy to surgery, critical issues in their use are represented by the extent of nodule reduction and by the durability of nodule reduction over a long period of time. Objective: To assess the ability of machine learning to discriminate nodules with volume reduction rate (VRR) < or ≥50% at 12 months following RF treatment. Methods: A machine learning model was trained with a dataset of 402 cytologically benign thyroid nodules subjected to RF at six Italian Institutions. The model was trained with the following variables: baseline nodule volume, echostructure, macrocalcalcifications, vascularity, and 12-month VRR. Results: After training, the model could distinguish between nodules having VRR < 50% from those having VRR ≥50% in 85% of cases (accuracy: 0.85; 95% confidence interval [CI]: 0.80-0.90; sensitivity: 0.70; 95% CI: 0.62-0.75; specificity: 0.99; 95% CI: 0.98-1.0; positive predictive value: 0.95; 95% CI: 0.92-0.98; negative predictive value: 0.95; 95% CI: 0.92-0.98). Conclusions: This study demonstrates that a machine learning model can reliably identify those nodules that will have VRR < or ≥50% at 12 months after one RF treatment session. Predicting which nodules will be poor or good responders represents valuable data that may help physicians and patients decide on the best treatment option between thermal ablation and surgery or in predicting if more than one session might be necessary to obtain a significant volume reduction.

show abstract

“…In a cross-sectional study, patients were significantly more satisfied with cosmetic results in the RFAtreated than in the surgical group, but no significant differences were demonstrated in overall satisfaction [63]. In a study of 404 patients, RFA resulted in significantly better HRQoL scores than thyroidectomy, and qualityadjusted life years following RFA were higher than following surgery [64].…”

Section: Radiofrequencymentioning

confidence: 94%

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

et al. 2020

View full text Add to dashboard Cite

Standard therapeutic approaches for benign thyroid lesions that warrant intervention are surgery for cold and either surgery or radioiodine for autonomously functioning thyroid nodules (AFTN). Image-guided thermal ablation (TA) procedures are increasingly proposed as therapy options for selected clinical conditions. Due to mounting scientific evidence and widening availability, ETA considered it appropriate to develop guidelines for the use of TA in adult patients. TA procedures are well tolerated, but a dedicated training of the operators is required and information on possible complications needs to be shared with the patients. The following factors should be considered when weighing between observation, surgery, and TA for benign thyroid nodules. In solid non-hyperfunctioning nodules, TA induces a decrease in thyroid nodule volume, paralleled by improvement in symptoms. Nodule re-growth is possible over time and may necessitate repeat treatment, or surgery, in a dialogue with the patient. In AFTN, radioactive iodine is the first-line treatment, but TA may be considered in young patients with small AFTN due to higher probability of restoring normal thyroid function and avoidance of irradiation. In cystic nodules, ethanol ablation (EA) is the most effective and least expensive treatment. TA may be considered for cystic lesions that relapse after EA or have a significant residual solid component following drainage and EA. TA should be restricted to benign lesions that cause symptoms or cosmetic concern. Presently, laser and radiofrequency ablation are the most thoroughly assessed techniques, with similar satisfactory clinical results. Microwaves and high-intensity focused ultrasound therapy options remain to be fully evaluated.© 2020 European Thyroid Association Published by S. Karger AG, Basel Recommendation 1. In adult patients with benign thyroid nodules that cause pressure symptoms and/or cosmetic concerns and decline surgery, image-guided TA should be considered as a costand risk-effective alternative option to surgical treatment or observation alone (1, ØØOO).Recommendation 2. We recommend against the use of TA for asymptomatic lesions (1, ØØØO).

show abstract

Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study

Cited by 71 publications

References 29 publications

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Comparison of efficacy and complications between radiofrequency ablation and repeat surgery in the treatment of locally recurrent thyroid cancers: a single-center propensity score matching study

Machine Learning Prediction of Radiofrequency Thermal Ablation Efficacy: A New Option to Optimize Thyroid Nodule Selection

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

Contact Info

Product

Resources

About