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Efficacy of thermal ablation in benign non-functioning solid thyroid nodule: A systematic review and meta-analysis

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Abstract

Background

Image-guided thermal ablations are commonly used in the treatment of thyroid nodules. Radiofrequency ablation (RFA) and laser ablation are the most commonly used. Here we aimed to obtain solid evidence of the long-term efficacy of RFA and laser ablation in benign non-functioning solid thyroid nodules (BNFSTN).

Methods

PubMed, CENTRAL, Scopus, and Web of Science were searched until March 2019. Studies reporting the effectiveness of RFA or laser ablation in patients with BNFSTN in terms of volume reduction rate (VRR), compressive symptoms and cosmetic concerns were included. Complications were also assessed.

Results

Out of 963 papers, 12 studies on RFA and 12 on laser ablation were included, assessing 1186 and 2009 BNFSTNs, respectively. Overall, VRR at 6, 12, 24, and 36 months was 60%, 66%, 62%, and 53%. VRR of RFA was 68%, 75%, and 87%, respectively. VRR of laser ablation was 48%, 52%, 45%, and 44%, respectively. Baseline volume of nodules undergone RFA was significantly smaller compared to laser ablation (20.1 ± 22.4 versus 24.6 ± 23.6 ml; p < 0.01). Nodules smaller than 30 ml obtained better outcomes than larger ones. A significant reduction in compressive symptoms and cosmetic concerns was found after RFA.

Conclusions

This meta-analysis showed that both RFA and laser ablation are able to obtain a significant volume reduction in BNFSTNs. A significant volume reduction is already evident at 6 months after thermal ablation and results are stable over the time.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Author notes

  1. These authors contributed equally: Pierpaolo Trimboli, Marco Castellana

Authors and Affiliations

  1. Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Pierpaolo Trimboli & Luca Giovanella

  2. Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy

    Marco Castellana & Francesco Giorgino

  3. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy

    Luca Maria Sconfienza

  4. IRCCS Istituto Ortopedico Galeazzi, Unit of Diagnostic and Interventional Radiology, Milano, Italy

    Luca Maria Sconfienza

  5. Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy

    Camilla Virili

  6. Postgraduation School in Radiodiagnostic, Università degli Studi di Milano, Milano, Italy

    Lorenzo Carlo Pescatori

  7. Unit of Metabolic Diseases, S.M.Goretti, Latina Hospital, Latina, Italy

    Roberto Cesareo

  8. Division of Endocrinology, “V. Fazzi” Hospital, Lecce, Italy

    Roberto Negro

  9. Clinic for Nuclear Medicine, University Hospital and University of Zurich, Zurich, Switzerland

    Luca Giovanella

  10. Division of Interventional Radiology, European Institute of Oncology IRCCS, Milan, Italy

    Giovanni Mauri

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  1. Pierpaolo Trimboli
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Correspondence to Luca Maria Sconfienza.

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G.M. consults for Elesta SrL. The remaining authors declare that they have no conflict of interest.

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Trimboli, P., Castellana, M., Sconfienza, L.M. et al. Efficacy of thermal ablation in benign non-functioning solid thyroid nodule: A systematic review and meta-analysis. Endocrine 67, 35–43 (2020). https://doi.org/10.1007/s12020-019-02019-3

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