Radiofrequency ablation vs. microwave ablation for patients with benign thyroid nodules: a propensity score matching study

Yue, Wenwen; Wang, Shurong; Lu, Feng; Sun, Liping; Guo, Le‐Hang; Zhang, Yonglin; Li, Xiaolong; Xu, Hui‐Xiong

doi:10.1007/s12020-016-1173-5

Cited by 81 publications

(64 citation statements)

References 32 publications

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“…MWA was also associated with a slightly higher complication rate than RFA (7 vs. 5%, respective-ly) [81]. These results have been confirmed by a retrospective study of 108 patients after propensity score adjustment [82].…”

Section: Comparison Of Outcomes Of Different Ta Techniques For Benignmentioning

confidence: 77%

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

et al. 2020

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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).

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Section: Comparison Of Outcomes Of Different Ta Techniques For Benignmentioning

confidence: 77%

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

et al. 2020

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“…Voice change is usually transient, and most patients recover spontaneously within 3 months without special treatments. [819212641424346] Prednisone may be useful for reducing the recovery period. [22] One patient experienced permanent right paramedian vocal cord palsy with inspiratory stridor but without dysphonia.…”

Section: Resultsmentioning

confidence: 99%

Complications Following Radiofrequency Ablation of Benign Thyroid Nodules

Wang

et al. 2017

Chinese Medical Journal

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Objective:This systematic review examined whether radiofrequency ablation (RFA) is a safe treatment modality for benign thyroid nodules (BTNs).Data Sources:PubMed, Embase, and the Cochrane Library database were searched for articles that (a) targeted human beings and (b) had a study population with BTNs that were confirmed by fine-needle aspiration cytology and/or core needle biopsy.Study Selection:Thirty-two studies relating to 3409 patients were included in this systematic review.Results:Based on literatures, no deaths were associated with the procedure, serious complications were rare, and RFA appears to be a safe and well-tolerated treatment modality. However, a broad spectrum of complications offers insights into some undesirable complications, such as track needle seeding and Horner syndrome.Conclusions:RFA appears to be a safe and well-tolerated treatment modality for BTNs. More research is needed to characterize the complications of RFA for thyroid nodules.

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“…A recent retrospective study 16 concluded that the VRRs achieved by RFA and MWA for the treatment of BTNs at 1, 3, 6 and 12 months follow-up were no statistical significance. To compare with the results of our study, except the influence of the number of the enrolled patients, a low microwave power output of 20-35 W might contribute to minimize the carbonization in the ablated nodules and increase the VRR of MWA group at follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…MWA seems to be a safe and effective technique for the treatment of BTNs 15 . A recent interesting study 16 retrospectively compared the clinical outcomes of RFA and MWA and concluded that both of them were effective and safe methods in treating BTNs. The purpose of the present prospective multicenter study was to further evaluate the clinical outcomes of the two techniques.…”

mentioning

confidence: 99%

US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: A prospective multicenter study.

Cheng

2017

JCO

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Compared with microwave ablation (MWA), percutaneous radiofrequency ablation (RFA) and laser ablation (LA) have been recommended as minimally invasive treatments for patients with symptomatic benign thyroid nodules (BTNs) because of the large number of clinical applications. This prospective multicenter study sought to evaluate the clinical outcomes of RFA and MWA for BTNs. In eight participating institutions, the total number of 1252 patients treated by RFA and MWA were 649 ones with 687 BTNs and 603 ones with 664 BTNs, respectively. The clinical outcomes including the nodular maximal diameter reduction ratio (MDRR), the nodular volume reduction ratio (VRR), and the incidence of complications were compared to evaluate the efficacy and safety of the two techniques. The results for the nodular MDRR and VRR in the RFA group were significantly better than those in the MWA group at 6 months and later follow-up, and the major complication rates of 4.78% and 6.63% in RFA and MWA groups showed no statistically significant differences. In conclusion, both RFA and MWA are safe and effective techniques for selected patients with symptomatic BTNs. The achieved MDRR and VRR in the RFA group were greater than those in the MWA group at 6 months and later follow-up.The thyroid nodule is one of the most common lesions in clinical practice 1 and has been increasingly detected in approximately 50% of the general population by ultrasound (US) examination 2 in the past two decades due to the widespread use of radiological imaging. Benign thyroid nodules (BTNs) proven cytologically by fine-needle aspiration biopsy (FNAB) account for 85 to 95% of all thyroid nodules 3 . It is unnecessary to treat most BTNs because of their lack of symptoms and slow growth 4 . Therapy is mainly focused on patients with progressive nodular growth or cosmetic problems and symptoms, which are related to nodular volume 5 . Therefore, it is essential for the treatment of BTNs to maximize the nodular volume reduction ratio (VRR) and minimize complications because of the anatomical features of the thyroid and its adjacent important structures.After over a decade of clinical application, percutaneous radiofrequency ablation (RFA) and laser ablation (LA) under US guidance have become minimally invasive treatments for patients with BTNs, especially for nonsurgical candidates, surgical high-risk individuals or those refusing surgery 5,6 . Low complication rates and high nodular VRRs for RFA and LA have been confirmed in the treatment of BTNs [7][8][9] , and the preservation of thyroid

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Radiofrequency ablation vs. microwave ablation for patients with benign thyroid nodules: a propensity score matching study

Cited by 81 publications

References 32 publications

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

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

Complications Following Radiofrequency Ablation of Benign Thyroid Nodules

US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: A prospective multicenter study.

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