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Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation
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BACKGROUND AND PURPOSE: Nodular goiter is one of the most common benign lesions in thyroid nodule. The main treatment of the disease is still the traditional surgical resection, however there are many problems such as general anesthesia, surgical scar, postoperative thyroid or parathyroid function abnormalities, and high nodules recurrence rate in residual gland. The purpose of this study was to compare the efficacy, safety, and cost-effectiveness of 2 treatment methods, surgery and radiofrequency ablation, for the treatment of benign thyroid nodules. MATERIALS AND METHODS: From May 2012 to September 2013, 200 patients with nodular goiters who underwent surgery (group A) and 200 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) hyperfunctioning nodules related to thyrotoxicosis, and 4) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18-ga internally cooled electrode were used. We compared the 2 groups in terms of efficacy, safety, and cost-effectiveness during a 1-year follow-up. RESULTS: After radiofrequency ablation, the nodule volume decreased significantly from 5.4 to 0.4 mL (P = .002) at the 12-month follow-up. The incidence of complications was significantly higher from surgery than from radiofrequency ablation (6.0% versus 1.0%, P = .002). Hypothyroidism was detected in 71.5% of patients after surgery but in none following radiofrequency ablation. The rate of residual nodules (11.9% versus 2.9%, P = .004) and hospitalization days was significantly greater after surgery (6.6 versus 2.1 days, P < .001), but the cost difference was not significant. CONCLUSIONS: Surgical resection and radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules.
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“A Korean study compared the use of RFA to surgery for nontoxic nodules (306).RFA was associated with an 85% reduction in nodule size, the cost was similar to surgery, there were fewer complications (RLN injury or hypoparathyroidism: 6% for surgery and 1% for RFA), and no patient who received RFA became hypothyroid (306).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [306]
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Metadata
- Authors
- Che, Y., Jin, S., Shi, C., Wang, L., Zhang, X., Li, Y., & Baek, J. H.
- Affiliations
- First Affiliated Hospital of Dalian Medical University (CN)
- Dalian Medical University (CN)
- Asan Medical Center (KR)
- Venue
- American Journal of Neuroradiology
- Published
- 2015-03-26
- Volume
- 36
- Issue
- 7
- Pages
- 1321-1325
- ISSN
- 0195-6108 (ISSN-L)
- 1936-959X
- PMC
- PMC7965284
- OpenAlex
- W2034580160
- Cited by
- 205
- References
- 34
- Citations by year
- 2026: 15 · 2025: 18 · 2024: 26 · 2023: 10 · 2022: 23 · 2021: 32 · 2020: 18 · 2019: 16 · 2018: 21 · 2017: 15 · 2016: 7 · 2015: 4
- FWCI
- 15.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- American Journal of Neuroradiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Keywords
- benign thyroid nodules, nodular goiter, radiofrequency ablation, thyroidectomy, surgical resection, hypothyroidism, postoperative complications, cost-effectiveness, length of hospital stay, thyrotoxicosis
- MeSH terms
- Adult, Aged, Female, Goiter, Humans, Male, Middle Aged, Postoperative Period, Thyroidectomy, Thyroid Nodule, Treatment Outcome, Catheter Ablation
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