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Radiofrequency ablation for treatment of benign thyroid nodules: Systematic review
Author(s) -
Fuller Colin W.,
Nguyen Shaun A.,
Lohia Shivangi,
Gillespie M. Boyd
Publication year - 2014
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24406
Subject(s) - medicine , radiofrequency ablation , thyroid nodules , adverse effect , nodule (geology) , placebo , randomized controlled trial , meta analysis , observational study , systematic review , surgery , medline , thyroid , radiology , ablation , pathology , alternative medicine , paleontology , political science , law , biology
Objective To summarize the literature published to date on the use of radiofrequency ablation (RFA) in the treatment of benign thyroid nodules, to evaluate the effectiveness of this treatment, and to attempt an evaluation of factors that may influence treatment outcome. Study Design Systematic review with meta‐analysis. Methods Systematic literature search was performed by two separate authors in four commonly used literature databases. Trials included in meta‐analysis included only those presenting prospective data. Meta‐analysis compared pretreatment values to post‐treatment outcomes. Results Of 46 full‐text articles identified, nine articles satisfied inclusion criteria. Two of these articles were randomized controlled trials comparing RFA to placebo or to some other treatment. One article was a randomized controlled trial comparing one RFA treatment to two treatments. The remaining six articles were noncontrolled, prospective observational studies. All analyzed outcomes showed statistically significant improvements from baseline to final follow‐up, including reduction in nodule size, improvement of symptom and cosmetic scores, and withdrawal from methimazole. Improvement in nodule size remained significant in both “hot” and “cold” nodule subgroups. Twelve adverse events were identified across all studies out of 306 total treatments. Two of these events qualified as significant adverse events. None of these events resulted in hospitalization or death. Conclusions Radiofrequency ablation is a safe and effective treatment for symptomatic thyroid nodules that are confirmed benign. However, the paucity of level 1 evidence comparing RFA to surgical or to other nonsurgical treatment modalities is concerning. Level of Evidence NA Laryngoscope , 124:346–353, 2014