Long-Term Results of Thermal Ablation of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis
Endocrinology and Metabolism 2020³â 35±Ç 2È£ p.339 ~ p.350
Á¶¼¼Áø(Cho Se-Jin) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
¹éÁ¤È¯(Baek Jung-Hwan) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
Á¤»õ·Ò(Chung Sae-Rom) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
ÃÖ¿µÁØ(Choi Young-Jun) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
ÀÌÁ¤Çö(Lee Jeong-Hyun) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
Abstract
Background: Ultrasound-guided thermal ablations have become one of the main options for treating benign thyroid nodules. To determine efficacy of thermal ablation of benign thyroid nodules, we performed a meta-analysis of studies with long-term follow-up of more than 3 years.
Methods: Databases were searched for studies published up to August 25, 2019, reporting patients with benign thyroid nodules treated with thermal ablation and with follow-up data of more than 3 years. Data extraction and quality assessment were performed according to PRISMA guidelines. The analysis yielded serial volume reduction rates (VRRs) of ablated nodules for up to 3 years or more, and adverse effect of ablation during follow-up. Radiofrequency ablation (RFA) and laser ablation (LA) were compared in a subgroup analysis.
Results: The pooled VRRs for ablated nodules showed rapid volume reduction before 12 months, a plateau from 12 to 36 months, and more volume reduction appearing after 36 months, demonstrating long-term maintenance of treatment efficacy. Thermal ablation had an acceptable complication rate of 3.8%. Moreover, patients undergoing nodule ablation showed no unexpected delayed complications during the follow-up period. In the subgroup analysis, RFA was shown to be superior to LA in terms of the pooled VRR and the number of patients who underwent delayed surgery.
Conclusion: Thermal ablations are safe and effective methods for treating benign thyroid nodules, as shown by a long follow-up analysis of more than 3 years. In addition, RFA showed superior VRRs compared with LA for the treatment of benign thyroid nodules, with less regrowth and less delayed surgery.
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Radio frequency ablation, Thyroid adenoma, Meta-analysis
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This systematic review found that long-term follow-up analysis of more than 3 years showed thermal ablations to be safe and effective methods for treating benign thyroid nodules.