Radiofrequency ablation and thyroid nodules: updated systematic review.

Area of Science:

• Endocrinology
• Minimally Invasive Procedures
• Oncology

Background:

• Radiofrequency ablation (RFA) is gaining international traction for thyroid conditions, including benign thyroid nodules (BTNs) and differentiated thyroid cancers (DTC).
• While surgery is standard for DTC, RFA presents an alternative for high-risk patients or those declining surgery, avoiding complications like hypothyroidism and voice changes.
• RFA is less established in North America compared to Asia and Europe, necessitating further evaluation.

Purpose of the Study:

• To review and evaluate existing evidence on the safety and efficacy of radiofrequency ablation for managing benign thyroid nodules and differentiated thyroid cancers.
• To assess the current data regarding radiofrequency ablation outcomes in thyroid conditions.

Main Methods:

• A systematic literature search was conducted across major databases including PubMed/MEDLINE, EMBASE, Clinical Queries, and Web of Science.
• The search covered articles published up to April 30th, 2020.
• Seventy-five studies met the inclusion criteria for the review.

Main Results:

• The review encompassed studies on RFA for solid nodules (35), cystic nodules (12), autonomously functioning thyroid nodules (10), and differentiated thyroid cancer (18).
• Evidence suggests RFA is effective for selected BTNs and DTC.
• Studies indicate a low rate of severe complications and minimal need for thyroid hormone replacement post-RFA.

Conclusions:

• Radiofrequency ablation (RFA) is a promising, safe, and effective alternative to traditional surgery for specific benign thyroid nodules and differentiated thyroid cancers.
• Its application is particularly relevant for patients with high surgical risks or those who prefer to avoid surgery.
• Further large-scale randomized controlled trials, especially in North American populations, are required to fully establish the role of RFA in thyroidology.