Comparative Meta-analysis of Radiofrequency Ablation and Microwave Ablation for the Treatment of Benign Thyroid Nodules

Abstract

Abstract:

Background: The efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) in treating benign thyroid nodules (BTNs) remains unclear. This study was aimed to compare the efficacy and safety of RFA and MWA in treating BTNs.

Methods: A systematic search of PubMed, Embase, and Cochrane databases was conducted up to September 11, 2023, to identify relevant studies. The primary outcomes included volume reduction rate (VRR), symptomatic and cosmetic scores analyzed using standardized mean difference (SMD), and complications assessed by risk difference (RD).

Results: A meta-analysis of five eligible studies demonstrated that RFA and MWA had comparable pooled 3-month and 6-month VRRs (56.0% vs. 53.9%, p = .668; 80.8% vs. 74.9%, p = .080). However, RFA exhibited a significantly higher VRR than MWA after 12 months (86.2% vs. 80.0%, p = .036). Furthermore, both RFA and MWA showed significant reductions in pooled symptomatic and cosmetic scores over time, with no statistically significant differences between the two groups at 6 and 12 months. Additionally, there were no significant differences in the incidence of major or minor complications between RFA and MWA.

Conclusion: The meta-analysis indicates that both RFA and MWA are effective and relatively safe treatments for BTNs, with RFA potentially offering a slight advantage in long-term volume reduction. Nevertheless, further research is warranted to validate these findings and determine the optimal treatment strategy for BTNs.

Keywords: radiofrequency ablation, microwave ablation, meta-analysis, benign thyroid nodules