Efficacy of thermal ablation in benign non-functioning solid thyroid nodule: A systematic review and meta-analysis

Area of Science:

• Endocrinology
• Minimally Invasive Surgery
• Oncology

Background:

• Image-guided thermal ablation is a common treatment for thyroid nodules.
• Radiofrequency ablation (RFA) and laser ablation are frequently employed techniques.
• Evidence on the long-term efficacy of these methods for benign non-functioning solid thyroid nodules (BNFSTN) requires consolidation.

Purpose of the Study:

• To evaluate the long-term effectiveness of RFA and laser ablation for BNFSTN.
• To compare the volume reduction rates and clinical outcomes between RFA and laser ablation.
• To assess complications associated with these thermal ablation techniques.

Main Methods:

• A systematic literature search was conducted across PubMed, CENTRAL, Scopus, and Web of Science up to March 2019.
• Included studies reported on RFA or laser ablation for BNFSTN, assessing volume reduction rate (VRR), compressive symptoms, and cosmetic concerns.
• Complications were also systematically evaluated.

Main Results:

• 12 studies on RFA (1186 nodules) and 12 on laser ablation (2009 nodules) were included.
• Overall VRR at 36 months was 53%, with RFA achieving 87% and laser ablation 44%.
• RFA demonstrated significant improvement in compressive symptoms and cosmetic concerns, with smaller nodules (<30ml) yielding better outcomes.

Conclusions:

• Both RFA and laser ablation provide significant long-term volume reduction for BNFSTN.
• Volume reduction is observable as early as 6 months post-ablation and remains stable.
• RFA appears to be more effective than laser ablation, particularly for smaller nodules.