Cho, Se Jin; Baek, Jung Hwan; Chung, Sae Rom; Choi, Young Jun; Lee, Jeong Hyun
Endocrinology and metabolism (Seoul, Korea)
2020Jun ; 35 ( 2 ) :339-350.
PMID : 32615718
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Cho, Se Jin -
Baek, Jung Hwan -
Chung, Sae Rom -
Choi, Young Jun -
Lee, Jeong Hyun -
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.
keyword
Meta-analysis; Thyroid adenoma; Radio frequency ablation
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