The long-term effects of thermal ablation for benign thyroid nodules: a systematic review and meta-analysis.

Background: Ultrasound-guided thermal ablation has become an option for treating benign thyroid nodules. To evaluate the long-term safety and efficacy of thermal ablation for benign thyroid nodules (BTNs), cases involving 3 years of follow-up were studied via a systematic review and meta-analysis.

Methods: Studies published up to January 2024 were searched in the MEDLINE, Embase, and Cochrane Library databases; these studies included 3 years of follow-up data on patients with BTNs who underwent thermal ablation therapy. The reduction in the mean nodule volume, volume reduction rate (VRR), rate of regrowth during follow-up, compression symptoms, postoperative cosmetic effects, and ablation complications during follow-up were analyzed over 3 years. In a subgroup analysis, laser ablation (LA), radiofrequency ablation (RFA), and microwave ablation (MWA) were compared.

Results: After 3 years of follow-up, the volumes of BTNs decreased significantly after thermal ablation (p < 0.00001). The VRR was 71.59%. The regrowth rate was 7.41%. The major complication rate was 1.96%. The symptom scores and cosmetic scores significantly decreased (p < 0.00001). According to our subgroup analysis, the combined VRR was 53.27% in the LA group, 79.51% in the RFA group and 89.68% in the MWA group. The regrowth rate in the MWA-treated patients was lower (1.96%) than that in the other groups. Although the rate of the major complication was slightly greater (1.96%), there were no statistically significant differences compared with those in the LA and RFA groups.

Conclusion: Long-term follow-up analysis indicated that thermal ablation is a safe and effective method for treating benign thyroid nodules. In addition, compared with RFA and LA, MWA may be more effective at treating benign thyroid nodules.

Key points: Question What is the long-term outcome of thermal ablation in the treatment of benign thyroid nodules? Findings Thermal ablation is safe and effective for benign thyroid nodules. Clinical relevance Laser ablation, radiofrequency ablation, and microwave ablation showed no difference in safety, but microwave ablation may be more effective in treating benign thyroid nodules.