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Complications Following Radiofrequency Ablation of Benign Thyroid Nodules: A Systematic Review.

ABSTRACT: This systematic review examined whether radiofrequency ablation (RFA) is a safe treatment modality for benign thyroid nodules (BTNs).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.Thirty-two studies relating to 3409 patients were included in this systematic review.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.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.

SUBMITTER: Wang JF

PROVIDER: S-EPMC5455047 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Complications Following Radiofrequency Ablation of Benign Thyroid Nodules: A Systematic Review.

Wang Jin-Fen JF Wu Tao T Hu Kun-Peng KP Xu Wen W Zheng Bo-Wen BW Tong Ge G Yao Zhi-Cheng ZC Liu Bo B Ren Jie J

Chinese medical journal 20170601 11

<h4>Objective</h4>This systematic review examined whether radiofrequency ablation (RFA) is a safe treatment modality for benign thyroid nodules (BTNs).<h4>Data sources</h4>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.<h4>Study selection</h4>Thirty-two studies relating to 3409 patients were included in this systema ...[more]

PMID: 28524837

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[Effective and Safe Application of Radiofrequency Ablation for Benign Thyroid Nodules].

Project description:Radiofrequency ablation (RFA) has been a representative, non-surgical treatment for benign thyroid nodules that cause cosmetic problems or compression symptoms. The procedure of RFA should be performed effectively and safely. This review discusses the patient selection, pre-procedure evaluation and planning, principles, devices, techniques, and complications with reference to the guidelines and research on thyroid RFA. In particular, this review will devote to introduce RFA techniques and to provide practical help in the implementation of this procedure.

| S-EPMC10585069 | biostudies-literature

Radiofrequency ablation for treatment of benign thyroid nodules: A PRISMA-compliant systematic review and meta-analysis of outcomes.

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| S-EPMC5400335 | biostudies-literature

Ultrasound-guided radiofrequency ablation (RFA) of benign symptomatic thyroid nodules - initial UK experience.

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| S-EPMC6599903 | biostudies-literature

US-Guided Percutaneous Radiofrequency versus Microwave Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study.

Project description: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.

| S-EPMC5573330 | biostudies-literature

Image-guided thermal ablation of benign thyroid nodules.

Project description:Purpose:To clarify some relevant and significant inconsistencies and inaccuracies in review by Mainini et al. entitled "Image-guided thermal ablation of benign thyroid nodules" published in Journal of Ultrasound to avoid giving incorrect information to the reader and prevent that operators make wrong choices in the use of various devices and technologies available. Results:Total cases treated with radiofrequency would be 2388 and not 2435 as reported in Table 1 of this review. The major, minor complications, and side effects in the partial group treated with laser technique and reported in this review are actually 1.2, 3.8, and 35.4%, respectively. In series of patients treated with laser ablation, including a total of 2345 patients, major and minor complications are 0.7 and 1.4%, respectively. The major complications of laser technology are less severe than RFA. Conclusions:Several points regarding the paper by Mainini et al. need to be discussed, and I advocate authors for replying to my considerations to clarify the issues raised.

| S-EPMC5698193 | biostudies-literature

Multicenter Study of Benign Thyroid Nodules with Radiofrequency Ablation: Results of 762 Cases over 4 Years in Taiwan.

Project description:To evaluate the effectiveness and safety of radiofrequency ablation (RFA) treatment for benign thyroid nodules (BTNs) in five medical centers in Taiwan. From April 2016 to July 2020, 762 patients underwent ultrasound guided RFA treatment of 826 benign thyroid nodules at five medical centers in Taiwan. The RFA procedure was performed by radiologists, otolaryngologists, or surgeons. Patients were grouped into three subgroups according to the initial volume of BTNs. The volume reduction ratio (VRR) of each nodule, and complications were analyzed at 1, 3, and 6 months after RFA treatment and the three groups compared. The large nodular group showed greater VRR compared to the other two groups at first 1-month follow-up. At 6-months follow-up, there was no significant difference of VRR among the three groups. Goiters with difference in size can attain a successful VRR (>50%) although different specialists demonstrated variable VRR after 6-months follow-up. A total of 40 (4.8%) complications were reported. All patients recovered spontaneously without surgery intervention. The reliability and safety of RFA for benign thyroid nodules had been established. RFA has gradually become an alternative to surgery in the treatment of benign thyroid nodules in Taiwan.

| S-EPMC8782025 | biostudies-literature

Efficacy of Ethanol Ablation for Benign Thyroid Cysts and Predominantly Cystic Nodules: A Systematic Review and Meta-Analysis.

Project description:BackgroundUltrasound-guided minimally invasive procedures are widely used to treat thyroid diseases. The objective of this study was to assess the efficacy and safety of ethanol ablation (EA) in comparison with other non-surgical options in the treatment of benign thyroid cystic nodules.MethodsWe conducted a systematic search of studies on EA for thyroid cystic nodules, mainly in the Ovid-MEDLINE and Embase, Web of Science, and Cochrane databases. The standardized mean difference (SMD) of the volume reduction ratio (VRR) after EA versus other non-surgical treatments comprised the primary outcome, whereas the odds ratio (OR) of therapeutic success rates between the two groups comprised the secondary outcome.ResultsThe meta-analysis included 19 studies (four randomized controlled trials and 15 non-randomized studies) with 1,514 participants. The cumulative VRR of EA was 83.908% (95% confidence interval [CI], 79.358% to 88.457%). EA had a significantly higher pooled VRR (SMD, 0.381; 95% CI, 0.028 to 0.734; P=0.030), but not a significantly higher pooled therapeutic success rate (OR, 0.867; 95% CI, 0.132 to 5.689; P=0.880), than other forms of non-surgical management including radiofrequency ablation (RFA), polidocanol sclerotherapy, and simple aspiration with or without saline flush. However, the VRR and therapeutic success rate were not significantly different between EA and RFA. Major complications were recorded only in six patients (0.53%) with self-limiting dysphonia.ConclusionThe role of EA as the first-line treatment for benign thyroid cysts and predominantly cystic nodules is supported by its high effectiveness and good safety profile compared to other currently available non-surgical options.

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Percutaneous laser ablation for benign thyroid nodules: a meta-analysis.

Project description:PurposeTo evaluate percutaneous laser ablation in treating benign thyroid nodules, we conducted a meta-analysis based on summarizing existing researches.Materials and methodsA literature search for clinical trial was performed in PubMed, Cochrane Library and Excerpt Medica Database. The qualities of included studies were evaluated. We calculated the indexes with mean difference. Heterogeneity and publication bias were tested and explored. We performed subgroup analyses and sensitivity analysis further.ResultsA total of 19 researches and 2137 patients were included in this meta-analysis. The pooled estimates of nodule volume were statistically significant after percutaneous laser ablation for 1 month, 3 month, 6month, 12month, 24month and 36month(P < 0.05). The pooled estimate of thyroid-stimulating hormone was statistically significant after percutaneous laser ablation for 1 and 12 month (P = 0.008 and P = 0.03). The pooled estimate of free triiodothyronine was no statistically significant after percutaneous laser ablation for all follow-up intervals. The pooled estimate of free tetraiodothyronin was statistically significant after percutaneous laser ablation1 month (P = 0.004). The pooled estimate of thyroglobulin was statistically significant after percutaneous laser ablation 24 month (P = 0.04). The heterogeneity was found and the source of heterogeneity was explored in nodule volume for 6 and 12 month. No publication bias was found.ConclusionsThis meta-analysis demonstrated that percutaneous laser ablation was safe and useful in shrinking benign thyroid nodules volume, improving thyroid function, relieving symptoms of pressure and esthetic, especial for hyper-vascular benign thyroid nodules. Larger number of high-quality prospective studies still needs to be performed.

| S-EPMC5669962 | biostudies-literature

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

Project description:This study is to compare the health-related quality of life (HRQoL) and cost-effectiveness of radiofrequency ablation (RFA) and open thyroidectomy (OT) for benign thyroid nodules (BTNs) treatment. HRQoL and utility were assessed for 404 BTN patients immediately before treatments (RFA:OT?=?137:267) and at 6-month visit. A cost-effectiveness analysis was performed from societal perspective in the China context. Resource use (hospitalization, sick leaves) was collected. We used the net monetary benefit approach and computed cost-effectiveness acceptability curves for RFA and OT. Sensitivity analyses of costs of RFA were performed. At 6-month visit, patients treated with RFA had significantly better HRQoL than patients treated with OT on general health (68.5 versus 66.7, P?=?0.029), vitality (71.3 versus 67.5, P?<?0.001) and mental health (80.9 versus 79.3, P?=?0.038). RFA was more effective than OT in terms of quality-adjusted life-years (QALYs; 0.01QALY/patient) but more expensive (US$823/patient). The probability that RFA would be cost effective at a US$50,000/QALY threshold was 15.5% in China, and it would be increased to 88.4% when price of the RFA device was lowered by 30%. RFA exhibited a significant improvement of HRQoL relative to OT, but is unlikely to be cost effective at its current price in short time.

| S-EPMC5121639 | biostudies-literature

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