top of page

Radiofrequency Ablation Compared to Surgery for the Treatment of Benign Thyroid Nodules

Radiofrequency Ablation Compared to Surgery for the Treatment of Benign Thyroid Nodules

Objective
Benign thyroid nodules are a common occurrence whose only remedy, in case of symptoms, has always been surgery until the advent of new techniques, such as radiofrequency ablation (RFA). This study aimed at evaluating RFA efficacy, tolerability, and costs and comparing them to hemithyroidectomy for the treatment of benign thyroid nodules.

Design and Methods
37 patients who underwent RFA were retrospectively compared to 74 patients surgically treated, either in a standard inpatient or in a short-stay surgical regimen. Efficacy, tolerability, and costs were compared. The contribution of final pathology was also taken into account.

Results
RFA reduced nodular volume by 70% after 12 months and it was an effective method for treating nodule-related clinical problems, but it was not as effective as surgery for the treatment of hot nodules. RFA and surgery were both safe, although RFA had less complications and pain was rare. RFA costed €1,661.50, surgery costed €4,556.30, and short-stay surgery costed €4,139.40 per patient. RFA, however, did not allow for any pathologic analysis of the nodules, which, in 6 patients who had undergone surgery (8%), revealed that the nodules harboured malignant cells.

Conclusions
RFA might transform our approach to benign thyroid nodules.

Conclusion

In conclusion, our comparative study suggests that RFA represents an effective alternative to surgery, which is very expensive and occasionally unnecessary, for the treatment of benign thyroid nodules causing local symptoms or cosmetic concerns. Nevertheless, this study does not dismiss surgery, which, on the contrary, is more effective than one RFA session for treating nodules with an initial volume greater than 35 mL as well as for autonomously functioning nodules. Since RFA does not allow for final pathology, patients should undergo two ultrasonographic-guided FNAB prior to the procedure and should be followed at least yearly for five years.

Citation

Bernardi S, Dobrinja C, Fabris B, et al. Radiofrequency ablation compared to surgery for the treatment of benign thyroid nodules. Int J Endocrinol. 2014;2014:934595. doi:10.1155/2014/934595

Key Words

RFA, Surgery, benign, thyroid nodule, radiofrequency ablation, hemithyroidectomy

bottom of page