Ha, Eun Ju; Baek, Jung Hwan; Kim, Kyung Won; Pyo, Junhee; Lee, Jeong Hyun; Baek, Seung Hee; Dossing, Helle; Hegedus, Laszlo
The Journal of clinical endocrinology and metabolism
2015May ; 100 ( 5 ) :1903-11.
PMID : 25695887
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Ha, Eun Ju -
Baek, Jung Hwan -
Kim, Kyung Won -
Pyo, Junhee -
Lee, Jeong Hyun -
Baek, Seung Hee -
Dossing, Helle -
Hegedus, Laszlo -
ABSTRACT
PURPOSE: To compare the efficacy of radiofrequency ablation (RFA) and laser ablation (LA) for treatment of benign solid thyroid nodules, using a systematic review including traditional pooling and Bayesian network meta-analysis. MATERIALS AND
METHODS: A comprehensive literature search in PubMed-MEDLINE, EMBASE, and the Cochrane Library databases identified prospective studies evaluating the percentage mean change [absolute mean change (mL)] in nodule volume after RFA or LA. Studies from January 1, 2000, to November 1, 2013, were included. Review of 128 potential papers, including a full-text review of 33, identified 10 eligible papers covering a total of 184 patients for meta-analysis. The percentage mean change [absolute mean change] in nodule volume over a 6-month follow-up was compared between RFA and LA.
RESULTS: Based on the traditional frequentist approach, the pooled percentage mean changes (95% confidence interval) of RFA and LA were 76.1% (70.1-82.1) and 49.9% (41.4-58.5), respectively, and the pooled absolute mean changes (95% confidence interval) of RFA and LA were 8.9 mL (6.6-11.2) and 5.2 mL (4.3-6.1), respectively. Based on the Bayesian network meta-analysis, RFA achieved a larger pooled percentage mean change (95% credible interval) and absolute mean change (95% credible interval) compared to LA [77.8% (67.7-88.0) vs 49.5% (26.7-72.4), and 9.2 mL (5.8-11.9) vs 5.3 mL (2.1-8.5), respectively]. The RFA group has the highest probability of having the most efficacious treatment (98.7%). There were no major complications after either RFA or LA.
CONCLUSIONS: RFA appears to be superior to LA in reducing benign solid thyroid nodule volume, despite the smaller number of treatment sessions without major side effects.
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MESH
Bayes Theorem, *Catheter Ablation, Humans, *Laser Therapy, Thyroid Nodule/*surgery, Treatment Outcome
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